Schreiner P J, Niemelä M, Miettinen H, Mähönen M, Ketonen M, Immonen-Räihä P, Lehto S, Vuorenmaa T, Palomäki P, Mustaniemi H, Kaarsalo E, Arstila M, Torppa J, Puska P, Tuomilehto J, Pyörälä K, Salomaa V
Division of Epidemiology, University of Minnesota, Minneapolis, MN, U.S.A.
Eur Heart J. 2001 May;22(9):762-8. doi: 10.1053/euhj.2000.2501.
Male gender is an established risk factor for first myocardial infarction, but some studies have suggested that among myocardial infarction survivors, women fare worse than men. Therefore, we examined the long-term prognosis of incident myocardial infarction survivors in a large, population-based MI register, addressing gender differences in mortality as well as the number of events and time intervals between recurrent events.
Study subjects included 4900 men and women, aged 25-64 years, with definite or probable first myocardial infarctions who were alive 28 days after the onset of symptoms. At first myocardial infarction, women were older and more likely to be hypertensive or diabetic than men, and had a greater proportion of probable vs definite events. After adjustment for age and geographic region, men had 1.74 times the risk of fatal coronary heart disease relative to women (hazard ratio=1.63 and 1.55 for cardiovascular disease and all-cause mortality, respectively) over an average of 5.9 years of follow-up. Number and time intervals between any recurrent event--fatal and non-fatal--did not differ by gender.
These data suggest that men are far more likely to have a fatal recurrent event than women despite comparable numbers of events.
男性是首次心肌梗死的既定风险因素，但一些研究表明，在心肌梗死幸存者中，女性的预后比男性更差。因此，我们在一个大型的、基于人群的心肌梗死登记处研究了首次发生心肌梗死的幸存者的长期预后，探讨了死亡率方面的性别差异以及复发事件的数量和时间间隔。
研究对象包括4900名年龄在25 - 64岁之间、有明确或可能的首次心肌梗死且在症状发作后28天仍存活的男性和女性。首次心肌梗死时，女性比男性年龄更大，更易患高血压或糖尿病，且可能事件的比例更高。在对年龄和地理区域进行调整后，在平均5.9年的随访中，男性发生致命性冠心病的风险是女性的1.74倍（心血管疾病和全因死亡率的风险比分别为1.63和1.55）。任何复发事件（致命和非致命）的数量和时间间隔在性别上没有差异。
这些数据表明，尽管复发事件的数量相当，但男性发生致命性复发事件的可能性远高于女性。
