Research article summary (published 24 Oct 2009):

Sex differences in mortality after acute myocardial infarction: changes from 1994 to 2006.

Full Abstract

BACKGROUND: Previous studies have shown that women younger than 55 years have higher hospital mortality rates after acute myocardial infarction (MI) than age-matched men. We examined whether such mortality differences have decreased in recent years. METHODS: We investigated temporal trends in the hospital case-fatality rates of MI by sex and age from June 1, 1994, through December 31, 2006. The study population included 916,380 patients from the National Registry of Myocardial Infarction with a confirmed diagnosis of MI. RESULTS: In-hospital mortality decreased markedly between 1994 and 2006 in all patients but more so in women than men. The mortality reduction in 2006 relative to 1994 was largest in women younger than 55 years (52.9%) and lowest in men younger than 55 years (33.3%). In patients younger than 55 years, the absolute decrease in mortality was 3 times larger in women than men (2.7% vs 0.9%). As a result, the excess mortality in younger women (<55 years) compared with men was less pronounced in 2004-2006 (unadjusted odds ratio, 1.32; 95% confidence interval, 1.07-1.67) than it was in 1994-1995 (unadjusted odds ratio, 1.93; 95% confidence interval, 1.67-2.24). The sex difference in mortality decrease was lower in older patients (P = .004 for the interaction among sex, age, and year). Changes in comorbidity and clinical severity features at admission accounted for more than 90% of these mortality trends. CONCLUSIONS: In recent years, women, particularly younger ones, experienced larger improvements in hospital mortality after MI than men. The narrowing of the mortality gap between younger women and men is largely attributable to temporal changes in risk profiles.

Author information

Author/s: Vaccarino, Viola (V); Parsons, Lori (L); Peterson, Eric D (ED); Rogers, William J (WJ); Kiefe, Catarina I (CI); Canto, John (J);

Affiliation: Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30306, USA. viola.vaccarino(-atsign-)emory.edu

Grants: K24HL077506 (Agency:NHLBI NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Archives of internal medicine (Arch Intern Med), published in United States. (Language: eng)

Reference: 2009-Oct; vol 169 (issue 19) : pp 1767-74

Dates: Created 2009/10/27; Completed 2009/11/05;

PMID: 19858434, status: MEDLINE (last retrieval date: 11/5/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Arch Intern Med. 2009 Oct 26;169(19):1740-1. (PMID: 19858428)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult Age Distribution Age Factors Aged Comorbidity Female Hospital Mortality - trends Humans Male

Male Middle Aged Myocardial Infarction - mortality Odds Ratio Severity of Illness Index Sex Distribution Sex Factors Survival Rate United States - epidemiology

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