Influence of gender on survival, mode of death, reinfarction, use of medication, and aspects of well being during a period of five years after onset of acute myocardial infarction.

BACKGROUND AND HYPOTHESIS

This study was undertaken to describe prognosis during a period of 5 years after an acute myocardial infarction (AMI) in relation to gender.

METHODS

All patients studied were hospitalized in a single hospital during a period of 21 months due to AMI, regardless of age and whether they were admitted to the coronary care unit or another ward. A total of 862 AMI patients [581 (67%) men and 281 (33%) women] were prospectively evaluated. Males were younger and less frequently had a history of congestive heart failure and hypertension.

RESULTS

The overall 5-year mortality rate was 48% among men compared with 61% among women (p < 0.001). However, in a multivariate analysis considering age, gender, and a previous history of cardiovascular diseases, female gender was not independently associated with death. Revascularization in terms of coronary artery bypass grafting and percutaneous transluminal angioplasty did not differ significantly between men and women. The rate of reinfarction was 34% among men and 38% among women (p > 0.2).

CONCLUSION

During 5 years of follow-up in a consecutive series of 862 AMI patients, women had a worse prognosis than men, with a mortality of 61% compared with 48% (p < 0.001). However, after controlling for a number of potentially confounding prognostic factors, female gender was not independently associated with mortality.