Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean acute myocardial infarction national registry)

Si Hyuck Kang, Jung Won Suh, Chang Hwan Yoon, Myeong Chan Cho, Young Jo Kim, Shung Chull Chae, Jung Han Yoon, Hyeon Cheol Gwon, Kyoo Rok Han, Joo Han Kim, Young Keun Ahn, Myung Ho Jeong, Hyo Soo Kim, Dong Ju Choi

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Abstract

There has been controversy over the disparity between men and women with regard to the management and prognosis of acute myocardial infarction. Analyzing nationwide multicenter prospective registries in Korea, the aim of this study was to determine whether female gender independently imposes a risk for mortality. Data from 14,253 patients who were hospitalized for ST-segment elevation myocardial infarction from November 2005 to September 2010 were extracted from registries. Compared to men, women were older (mean age 56 ± 12 vs 67 ± 10 years, p <0.001), and female gender was associated with a higher frequency of co-morbidities, including hypertension, diabetes, and dyslipidemia. Women had longer pain-to-door time and more severe hemodynamic status than men. All-cause mortality rates were 13.6% in women and 7.0% in men at 1 year after the index admission (hazard ratio for women 2.01, 95% confidence interval 1.80 to 2.25, p <0.001). The risk for death after ST-segment elevation myocardial infarction corresponded highly with age. Although the risk remained high after adjusting for age, further analyses adjusting for medical history, clinical performance, and hemodynamic status diminished the gender effect (hazard ratio 1.00, 95% confidence interval 0.86 to 1.17, p = 0.821). Propensity score matching, as a sensitivity analysis, corroborated the results. In conclusion, this study shows that women have a comparable risk for death after ST-segment elevation myocardial infarction as men. The gender effect was accounted for mostly by the women's older age, complex co-morbidities, and severe hemodynamic conditions at presentation.

Original languageEnglish
Pages (from-to)787-793
Number of pages7
JournalAmerican Journal of Cardiology
Volume109
Issue number6
DOIs
Publication statusPublished - 2012 Mar 15

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Kang, S. H., Suh, J. W., Yoon, C. H., Cho, M. C., Kim, Y. J., Chae, S. C., Yoon, J. H., Gwon, H. C., Han, K. R., Kim, J. H., Ahn, Y. K., Jeong, M. H., Kim, H. S., & Choi, D. J. (2012). Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean acute myocardial infarction national registry). American Journal of Cardiology, 109(6), 787-793. https://doi.org/10.1016/j.amjcard.2011.11.006