Fiebach N H, Viscoli C M, Horwitz R I
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
JAMA. 1990 Feb 23;263(8):1092-6.
To examine the impact of gender on survival after myocardial infarction, we performed a retrospective cohort study of 332 women and 790 men. Women who had a myocardial infarction were older and more often had hypertension, diabetes, previous heart failure, and impaired left ventricular function on admission. Cumulative 3-year mortality and in-hospital mortality rates were significantly higher in women than men, but mortality among hospital survivors was similar. After multivariate adjustment for baseline differences, mortality rates were not significantly different between women and men for in-hospital deaths, and mortality at 3 years among hospital survivors tended to be lower among women. We conclude that higher observed mortality rates following a myocardial infarction in women are related to differences in known risk factors for subsequent mortality and that gender should not be considered an independent risk factor for mortality after myocardial infarction.
为研究性别对心肌梗死后生存率的影响，我们对332名女性和790名男性进行了一项回顾性队列研究。发生心肌梗死的女性年龄更大，入院时更常患有高血压、糖尿病、既往心力衰竭以及左心室功能受损。女性的3年累积死亡率和住院死亡率显著高于男性，但医院幸存者中的死亡率相似。在对基线差异进行多变量调整后，女性和男性的住院死亡死亡率无显著差异，且医院幸存者中女性3年死亡率往往更低。我们得出结论，女性心肌梗死后观察到的较高死亡率与后续死亡的已知风险因素差异有关，性别不应被视为心肌梗死后死亡的独立风险因素。
