University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Am J Cardiol. 2010 Jul 1;106(1):26-30. doi: 10.1016/j.amjcard.2010.02.013. Epub 2010 May 13.
Young women hospitalized with acute myocardial infarction (MI) have greater in-hospital mortality than young men. However, the reasons for this difference have not been well characterized. We analyzed the data from 423,067 patients (247,701 men and 175,366 women) who were discharged with the diagnosis of MI from nonfederal hospitals in New Jersey and 355,569 coronary heart disease (CHD) deaths in New Jersey from 1990 to 2004 in 4 age strata: 35 to 54, 55 to 64, 65 to 74 and > or =75 years. Of the patients hospitalized for MI, young (35 to 54 years) women had greater in-hospital mortality than young men (5.2% vs 2.5%, adjusted odds ratio 1.64, 95% confidence interval 1.48 to 1.81, p <0.0001). However, in a community-wide analysis, when the total out-of-hospital CHD deaths in New Jersey were examined, young women had a lower out-of-hospital death rate than young men (11 vs 55/100,000). Statewide, young women were 4 times less likely to be hospitalized for MI (78 vs 297/100,000, relative risk 0.26), but they were only 1/2 as likely to die from MI in the hospital (7 vs 17/100,000, relative risk 0.41). Thus, women had a greater odds ratio for in-hospital mortality but a lower odds ratio for out-of-hospital CHD death than men. In conclusion, the greater in-hospital mortality of young women hospitalized for MI compared to young men could be explained in part by the finding that young men were more likely to have out-of-hospital CHD death.
年轻女性因急性心肌梗死（MI）住院的死亡率高于年轻男性。然而，导致这种差异的原因尚未得到充分描述。我们分析了 1990 年至 2004 年新泽西州非联邦医院出院诊断为 MI 的 423,067 例患者（男 247,701 例，女 175,366 例）和新泽西州 355,569 例冠心病（CHD）死亡数据，分为 4 个年龄组：35 至 54 岁、55 至 64 岁、65 至 74 岁和≥75 岁。在因 MI 住院的患者中，年轻（35 至 54 岁）女性的院内死亡率高于年轻男性（5.2%比 2.5%，调整比值比 1.64，95%置信区间 1.48 至 1.81，p<0.0001）。然而，在一项全社区分析中，当检查新泽西州的总 CHD 院外死亡人数时，年轻女性的院外死亡率低于年轻男性（11 比 55/100,000）。全州范围内，年轻女性因 MI 住院的可能性低 4 倍（78 比 297/100,000，相对风险 0.26），但她们在医院死于 MI 的可能性仅为男性的一半（7 比 17/100,000，相对风险 0.41）。因此，女性的院内死亡率比值比更高，但院外 CHD 死亡比值比更低。总之，与年轻男性相比，年轻女性因 MI 住院的死亡率更高，部分原因可能是年轻男性更有可能死于院外 CHD。
