Younger age potentiates post myocardial infarction survival disadvantage of women
Female patients with acute myocardial infarction (MI) exhibit higher unadjusted in-hospital mortality rates compared to male patients. However, contradictory evidence exists on whether this survival disadvantage disappears after adjustment for age and other prognostic factors. This study, based on a...
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Published in | International journal of cardiology Vol. 108; no. 3; pp. 320 - 325 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
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Elsevier Ireland Ltd
14.04.2006
Elsevier Science |
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Abstract | Female patients with acute myocardial infarction (MI) exhibit higher unadjusted in-hospital mortality rates compared to male patients. However, contradictory evidence exists on whether this survival disadvantage disappears after adjustment for age and other prognostic factors. This study, based on a countrywide survey of consecutive unselected patients with acute MI, examined whether female gender is an independent predictor of poor short-term outcome and less intensive in-hospital treatment.
Data on a total of 7433 patients were analyzed.
The mean age was 64
±
13 years and the proportion of females in this population was 23%. Univariate and multivariate predictors of in-hospital mortality in female patients were estimated. Unadjusted in-hospital mortality rates of women were significantly higher compared to men (17.7 vs. 8.6,
p
<
0.001). In multivariate analysis, female gender was an independent predictor of in-hospital mortality in the total population [relative risk (RR)
=
1.29, 95% confidence interval (CI)
=
1.02–1.64,
p
=
0.036]. The RR of women for in-hospital death was exaggerated among younger patients, aged <
55 years (RR
=
3.84, 95% CI
=
1.07–13.74,
p
=
0.039). Female gender was also independently and inversely associated with administration of thrombolytic treatment (RR
=
0.724, 95% CI
=
0.630–0.831,
p
=
<0.001).
Although female gender is an independent predictor of higher post-MI in-hospital mortality with a pronounced effect among younger patients, women are less likely to receive thrombolysis than men. Based on the results from this countrywide study, we should consider women, especially of younger age, as patients at particular high risk, who contrary to common practice, deserve more intensive and aggressive in-hospital treatment. |
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AbstractList | Female patients with acute myocardial infarction (MI) exhibit higher unadjusted in-hospital mortality rates compared to male patients. However, contradictory evidence exists on whether this survival disadvantage disappears after adjustment for age and other prognostic factors. This study, based on a countrywide survey of consecutive unselected patients with acute MI, examined whether female gender is an independent predictor of poor short-term outcome and less intensive in-hospital treatment.
Data on a total of 7433 patients were analyzed.
The mean age was 64+/-13 years and the proportion of females in this population was 23%. Univariate and multivariate predictors of in-hospital mortality in female patients were estimated. Unadjusted in-hospital mortality rates of women were significantly higher compared to men (17.7 vs. 8.6, p<0.001). In multivariate analysis, female gender was an independent predictor of in-hospital mortality in the total population [relative risk (RR)=1.29, 95% confidence interval (CI)=1.02-1.64, p=0.036]. The RR of women for in-hospital death was exaggerated among younger patients, aged <55 years (RR=3.84, 95% CI=1.07-13.74, p=0.039). Female gender was also independently and inversely associated with administration of thrombolytic treatment (RR=0.724, 95% CI=0.630-0.831, p=<0.001).
Although female gender is an independent predictor of higher post-MI in-hospital mortality with a pronounced effect among younger patients, women are less likely to receive thrombolysis than men. Based on the results from this countrywide study, we should consider women, especially of younger age, as patients at particular high risk, who contrary to common practice, deserve more intensive and aggressive in-hospital treatment. Female patients with acute myocardial infarction (MI) exhibit higher unadjusted in-hospital mortality rates compared to male patients. However, contradictory evidence exists on whether this survival disadvantage disappears after adjustment for age and other prognostic factors. This study, based on a countrywide survey of consecutive unselected patients with acute MI, examined whether female gender is an independent predictor of poor short-term outcome and less intensive in-hospital treatment. Data on a total of 7433 patients were analyzed. The mean age was 64 ± 13 years and the proportion of females in this population was 23%. Univariate and multivariate predictors of in-hospital mortality in female patients were estimated. Unadjusted in-hospital mortality rates of women were significantly higher compared to men (17.7 vs. 8.6, p < 0.001). In multivariate analysis, female gender was an independent predictor of in-hospital mortality in the total population [relative risk (RR) = 1.29, 95% confidence interval (CI) = 1.02–1.64, p = 0.036]. The RR of women for in-hospital death was exaggerated among younger patients, aged < 55 years (RR = 3.84, 95% CI = 1.07–13.74, p = 0.039). Female gender was also independently and inversely associated with administration of thrombolytic treatment (RR = 0.724, 95% CI = 0.630–0.831, p = <0.001). Although female gender is an independent predictor of higher post-MI in-hospital mortality with a pronounced effect among younger patients, women are less likely to receive thrombolysis than men. Based on the results from this countrywide study, we should consider women, especially of younger age, as patients at particular high risk, who contrary to common practice, deserve more intensive and aggressive in-hospital treatment. BACKGROUNDFemale patients with acute myocardial infarction (MI) exhibit higher unadjusted in-hospital mortality rates compared to male patients. However, contradictory evidence exists on whether this survival disadvantage disappears after adjustment for age and other prognostic factors. This study, based on a countrywide survey of consecutive unselected patients with acute MI, examined whether female gender is an independent predictor of poor short-term outcome and less intensive in-hospital treatment.METHODSData on a total of 7433 patients were analyzed.RESULTSThe mean age was 64+/-13 years and the proportion of females in this population was 23%. Univariate and multivariate predictors of in-hospital mortality in female patients were estimated. Unadjusted in-hospital mortality rates of women were significantly higher compared to men (17.7 vs. 8.6, p<0.001). In multivariate analysis, female gender was an independent predictor of in-hospital mortality in the total population [relative risk (RR)=1.29, 95% confidence interval (CI)=1.02-1.64, p=0.036]. The RR of women for in-hospital death was exaggerated among younger patients, aged <55 years (RR=3.84, 95% CI=1.07-13.74, p=0.039). Female gender was also independently and inversely associated with administration of thrombolytic treatment (RR=0.724, 95% CI=0.630-0.831, p=<0.001).CONCLUSIONAlthough female gender is an independent predictor of higher post-MI in-hospital mortality with a pronounced effect among younger patients, women are less likely to receive thrombolysis than men. Based on the results from this countrywide study, we should consider women, especially of younger age, as patients at particular high risk, who contrary to common practice, deserve more intensive and aggressive in-hospital treatment. |
Author | Toutouzas, Pavlos K. Tzeis, Stylianos E. Andrikopoulos, George K. Richter, Dimitri J. Stefanadis, Christodoulos I. Kappos, Konstantinos G. Pipilis, Athanasios G. Chimonas, Elias T. |
Author_xml | – sequence: 1 givenname: George K. surname: Andrikopoulos fullname: Andrikopoulos, George K. email: geomabuz@otenet.gr organization: First Cardiac department, Evangelismos Hospital, Athens, Greece – sequence: 2 givenname: Stylianos E. surname: Tzeis fullname: Tzeis, Stylianos E. organization: First Cardiac department, Evangelismos Hospital, Athens, Greece – sequence: 3 givenname: Athanasios G. surname: Pipilis fullname: Pipilis, Athanasios G. organization: Cardiac department, Ygeia Hospital, Athens, Greece – sequence: 4 givenname: Dimitri J. surname: Richter fullname: Richter, Dimitri J. organization: Second Cardiac department, Euroclinic Hospital, Athens, Greece – sequence: 5 givenname: Konstantinos G. surname: Kappos fullname: Kappos, Konstantinos G. organization: First Cardiac department, Evangelismos Hospital, Athens, Greece – sequence: 6 givenname: Christodoulos I. surname: Stefanadis fullname: Stefanadis, Christodoulos I. organization: Cardiac department of Athens University, Hippokration Hospital, Athens, Greece – sequence: 7 givenname: Pavlos K. surname: Toutouzas fullname: Toutouzas, Pavlos K. organization: Hellenic Heart Foundation, Athens, Greece – sequence: 8 givenname: Elias T. surname: Chimonas fullname: Chimonas, Elias T. organization: Cardiac department of 251 Airforce Hospital, Athens, Greece |
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Keywords | Post myocardial infarction Survival disadvantage of women Younger age Human Myocardial infarction Prognosis Cardiovascular disease Myocardial disease Phlebology Survival Disadvantage Heart disease Circulatory system Cardiology Woman Age |
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Snippet | Female patients with acute myocardial infarction (MI) exhibit higher unadjusted in-hospital mortality rates compared to male patients. However, contradictory... BACKGROUNDFemale patients with acute myocardial infarction (MI) exhibit higher unadjusted in-hospital mortality rates compared to male patients. However,... |
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SubjectTerms | Age Factors Aged Biological and medical sciences Cardiology. Vascular system Comorbidity Coronary heart disease Female Heart Humans Male Medical sciences Middle Aged Multivariate Analysis Myocardial Infarction - drug therapy Myocardial Infarction - epidemiology Myocardial Infarction - mortality Myocarditis. Cardiomyopathies Post myocardial infarction Sex Factors Survival disadvantage of women Thrombolytic Therapy Younger age |
Title | Younger age potentiates post myocardial infarction survival disadvantage of women |
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