Mehilli Julinda, Kastrati Adnan, Dirschinger Josef, Pache Jürgen, Seyfarth Melchior, Blasini Rudolf, Hall Donald, Neumann Franz-Josef, Schömig Albert
Deutsches Herzzentrum, Lazarettstrasse 36, 80636 Munich, Germany.
JAMA. 2002 Jan 9;287(2):210-5. doi: 10.1001/jama.287.2.210.
A higher mortality risk for women with acute myocardial infarction (AMI) is a common finding in studies that compare the postinfarction outcome of women vs men. It is not clear, however, whether sex is an independent predictor of death among patients systematically treated with aggressive reperfusion and medical strategies.
To assess the impact of patient's sex on outcome in a consecutive series of patients with AMI treated with a reperfusion strategy largely based on percutaneous coronary interventions.
DESIGN, SETTING, AND PATIENTS: Inception cohort of 1937 patients (502 women and 1435 men) who were admitted with a diagnosis of AMI to a tertiary referral institution between January 1995 and December 2000.
Mortality at 1 year after AMI.
Compared with men, women were older (70 vs 61 years; P<.001) and had known diabetes or hypertension more often. Both men and women received essentially identical therapy with the majority of patients (86%) receiving reperfusion therapy via percutaneous coronary interventions. There were no significant differences in 1-year Kaplan-Meier death rates with 13.8% (68 cases) among women and 12.9% (184 cases) among men (unadjusted hazard ratio, 1.06; 95% confidence interval, 0.80-1.39; P =.70). After age adjustment, women had a lower risk of death (hazard ratio, 0.65; 95% confidence interval, 0.49-0.87; P =.004).
Despite their more advanced age and greater prevalence of diabetes or hypertension, women with AMI who were treated with a reperfusion strategy largely based on percutaneous coronary interventions show a similar outcome as men.
在比较急性心肌梗死（AMI）女性与男性梗死后结局的研究中，女性较高的死亡风险是一个常见发现。然而，在接受积极再灌注和药物治疗的患者中，性别是否是死亡的独立预测因素尚不清楚。
评估在一系列主要基于经皮冠状动脉介入治疗的再灌注策略治疗的AMI患者中，患者性别对结局的影响。
设计、地点和患者：1995年1月至2000年12月期间，一所三级转诊机构收治的1937例诊断为AMI的患者（502例女性和1435例男性）的起始队列。
AMI后1年的死亡率。
与男性相比，女性年龄更大（70岁对61岁；P<0.001），且更常患有已知的糖尿病或高血压。男性和女性接受的治疗基本相同，大多数患者（86%）通过经皮冠状动脉介入治疗接受再灌注治疗。女性1年的Kaplan-Meier死亡率为13.8%（68例），男性为12.9%（184例），差异无统计学意义（未调整的风险比，1.06；95%置信区间，0.80-1.39；P = 0.70）。年龄调整后，女性的死亡风险较低（风险比，0.65；95%置信区间，0.49-0.87；P = 0.004）。
尽管年龄较大且糖尿病或高血压患病率较高，但接受主要基于经皮冠状动脉介入治疗的再灌注策略的AMI女性与男性结局相似。
