Abstract 1043: Has the Sex Gap in 30-Day Mortality Post Acute Myocardial Infarction Narrowed in Recent Years?
Background: Studies in early 1990s showed that women had higher risk for short term mortality post AMI compared to men. Considering the overall improvements in treatment of AMI and increased awareness of cardiovascular disease in women, we hypothesized that the sex gap in 30-day AMI mortality has been reduced over time.
Method: The data were obtained from the British Columbia (BC) Hospitalization Database. All BC patients ≥20 years of age, with their first AMI admission between 1994 and 2003, were included. The temporal trends in 30-day mortality post index AMI for both men and women were assessed using a logistic regression model with an interaction term for sex and admission year, adjusting for patient age, co-morbid conditions and neighborhood income.
Results: A total of 45,024 patients were included in the study, of which 34.5% were women. The 30-day mortality post AMI was overall 19.0% in women and 13.0% in men (p-value<0.001), and declined for both men and women during the study period (p-value for trend<0.0001). However, the magnitude of the decline was more pronounced in women than men, falling from 20.0% to 15.2% and from 13.7% to 11.1% respectively. The adjusted odds ratios for 30-day mortality in women versus men are presented in the Figure⇓. Women had a greater odds of 30-day mortality in earlier years and there was a trend towards comparable odds in recent years (p-value for sex and admission year interaction=0.08).
Conclusions: Our study provides population based evidence for attenuation of the sex gap in 30-day mortality post AMI. This improvement could be attributable to improvements in care and awareness of cardiovascular disease in women over the recent decade.