Gender differences in the management and outcome of acute myocardial infarction in unselected patients in the thrombolytic era
Section snippets
Patients
Methods of patient ascertainment and data collection for this historical cohort study of unselected, consecutive patients with AMI who were admitted to 1 center during the thrombolytic era have been described in detail elsewhere.17 Briefly, all patients admitted to a university cardiac center between June 1992 and December 1994 with primary or secondary diagnosis of AMI were identified for inclusion using the Hospital In-Patient Enquiry (HIPE) database, which includes demographic, diagnostic,
Results
TABLE I, TABLE II, TABLE IIIdelineate gender differences in demographic and risk factor profiles, site and complications of AMI, and management, respectively. Of 1,059 patients, 397 were women (40%). Mean age was 70.9 (±12.9) years versus 64.7 (±13) years in men (p <0.001). There were no gender differences regarding the site of AMI. When unadjusted for age, women were less likely to have a history of cigarette smoking, more likely to be hypertensive (Table I), had a higher hospital mortality
Discussion
This study of unselected, consecutive patients with AMI demonstrates a significantly higher hospital mortality rate and a higher rate of nonfatal complications among women. This is associated with gender differences in demographics, risk factor profiles, and (in subgroups) management strategies.
Acknowledgements
We gratefully acknowledge the assistance of Sister Bernadette Egan and Sister Anna Hennessey in the completion of this study, and Mark M. Gallagher, MD, for critically reviewing the manuscript.
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