Coronary artery diseaseGender–Age Interaction in Early Mortality Following Primary Angioplasty for Acute Myocardial Infarction††
Section snippets
Methods
The study population consisted of 9,015 consecutive patients who underwent primary angioplasty for AMI in New York State between January 1, 1997 and December 31, 1999. Patients were included in the analysis if they underwent attempted angioplasty for AMI within 23 hours of symptom onset. This definition of primary angioplasty is consistent with that used by the Society of Cardiac Angiography and Interventions.5
Prospectively defined data elements including demographics, co-morbidities,
Results
In total, 9,015 patients with AMI were treated with primary angioplasty, of whom 2,619 (29%) were women. Table 1 lists the baseline characteristics of women and men in this analysis. Women were older (66 vs 59 years, p <0.001) and had a higher prevalence of hypertension (64% vs 52%, p <0.001), diabetes (23% vs 15%, p <0.001), and peripheral vascular disease (8% vs 5% p <0.001) than men. Race and body mass index did not differ between genders. Women were less likely to have a history of MI (43%
Discussion
Two significant findings emerge from this study. First, in this cohort of unselected patients treated with primary angioplasty for AMI, women had increased unadjusted in-hospital mortality compared with men that was no longer significant after adjustment for demographics, co-morbidities, and clinical presentation. Second, when examining the interaction of gender with age, our study demonstrated a marked difference in outcome after AMI for women versus men when stratified by age. Among patients
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The views presented are those of the authors and may not reflect those of the New York State Department of Health or the Cardiac Advisory Committee.