Abstract 5021: The Paradox of Gender in Long-Term Survival Following AMI: A Comparison of the 1995 and 2001 Minnesota Heart Survey Cohorts
Improved mortality following acute myocardial infarction (AMI) has been observed in recent decades. We sought to identify how improved adherence to standard pharmacologic therapies and widespread use of percutaneous coronary intervention (PCI) impact mortality in men (M) and women (W). The Minnesota Heart Survey (MHS) abstracted a random sample of all medical records from patients age 30 –74 hospitalized with an AMI in the Minneapolis metro area in 1995 and 2001. Hospital mortality was ascertained from the medical record and verified using death certificates. General linear models were used to compare the outcomes of M and W between the 1995 and 2001 surveys. Survival curves were estimated using Cox proportional hazard models incorporating demographic factors and baseline characteristics. We identified 1313 AMI patients (764 M, 549 W) in 1995 and 1518 AMI patients (630 M, 888 W) in 2001. W were younger in 2001 compared to 1995; there was no significant age difference in M. The prevalence of hypertension and diabetes in AMI patients increased between 1995 and 2001. The use of aspirin, beta-blockers and ACE inhibitors during hospitalization as well as coronary angiography and PCI significantly increased between 1995 and 2001. There was a significant decline in hospital length of stay for M (2.0 days) and W (1.5 days). There was a significant decline in 3-year adjusted mortality for M but a nonsignificant increase in mortality in W [Figure⇓]. Improved utilization of recommended AMI pharmacologic therapies and coronary revascularization between 1995 and 2001 in M and W have only translated into improved survival among M in a population-based study.