Karlson B W, Herlitz J, Hartford M
Division of Cardiology, Sahlgrenska Hospital, University of Göteborg.
Am Heart J. 1994 Sep;128(3):477-83. doi: 10.1016/0002-8703(94)90620-3.
We studied 921 consecutive patients admitted to a single hospital for acute myocardial infarction during a period of 21 months and related their prognosis to gender. Women (n = 300, 33%) were on average 7 years older (p < 0.001) and more frequently had a previous history of hypertension (p < 0.001) and congestive heart failure (p < 0.001) than did men. They also tended to delay longer in seeking medical treatment and more often presented with only vague symptoms (p < 0.05). The in-hospital mortality for women was 19% versus 12% for men (p < 0.01). Women more often showed signs of congestive heart failure (p < 0.05) despite smaller infarcts as estimated from enzyme levels (p < 0.05). Total mortality during 1 year was 36% in women and 25% in men (p < 0.01). In a multivariate analysis, female gender did not appear as an independent risk factor for death. During 1 year of follow-up no differences in morbidity were observed between the sexes. We conclude that if women fare worse than men after suffering an acute myocardial infarction, the increased mortality is accounted for by older age.
我们研究了在21个月期间因急性心肌梗死入住一家医院的921例连续患者，并将他们的预后与性别相关联。女性（n = 300，33%）平均比男性大7岁（p < 0.001），且比男性更频繁地有高血压病史（p < 0.001）和充血性心力衰竭病史（p < 0.001）。她们在寻求医疗治疗方面也往往延迟更长时间，并且更常仅表现出模糊的症状（p < 0.05）。女性的住院死亡率为19%，而男性为12%（p < 0.01）。尽管根据酶水平估计梗死面积较小（p < 0.05），但女性更常出现充血性心力衰竭的体征（p < 0.05）。女性1年的总死亡率为36%，男性为25%（p < 0.01）。在多变量分析中，女性性别未表现为死亡的独立危险因素。在1年的随访期间，未观察到两性之间在发病率上的差异。我们得出结论，如果女性在急性心肌梗死后比男性情况更差，那么死亡率增加是由年龄较大所致。
