Abstract 12895: Factors Influencing the Higher In-Hospital Mortality of Female Patients with Acute Myocardial Infarction
Background: We have previously demonstrated that in-hospital mortality after acute myocardial infarction (AMI) is higher in female patients than in male patients; however, the underlying cause(s) remains to be fully elucidated. Coronary reperfusion therapy has significantly improved the survival rate of AMI patients; however, the sex difference in the in-hospital mortality needs to be improved. In this study, we examined the sex difference in the time course from AMI onset to coronary reperfusion.
Methods: In our MIYAGI-AMI registry study, a total of 3,119 patients with AMI were registered between 2008 and 2010. Among these patients, we excluded the patients who admitted more than 24 hours after AMI onset and finally analyzed 1,195 patients (M/F 894/301; average age, 64.6±12.8 / 74.3±11.3 years). We then divided them into 3 groups by age (A1, age≤65, n=489; A2, 6580, n=220). We compared the time course from AMI onset to coronary reperfusion in both sexes of each group.
Results: The elapsing time from AMI onset to hospital arrival (T1 [median], M 259 vs. F 323 min), the time from AMI onset to start of coronary angiography (T2, 322 vs. 385 min), and the time from AMI onset to coronary reperfusion (T3: 354 vs. 414 min) were all significantly longer in female patients than in male patients (all P<0.01). In contrast, the time from hospital arrival to coronary reperfusion (T3 - T1), so called door-to-balloon time, was comparable between both sexes (95 vs. 92 min, P = 0.71), indicating that the time delay for reperfusion in female patients could be attributable to the delay in T1. Furthermore, we analyzed the time course in each age group and found that there was no difference in the time periods (T1, T2, and T3) between A1 and A2 in both sexes, whereas in the oldest A3 group, all the time periods were markedly longer in female than in male patients (T1, M 264 vs. F 353 min; T2, 343 vs. 422 min; T3, 377 vs. 456 min, all P<0.05).
Conclusions: These results indicate that it takes longer time with female patients than in male patients, especially elderly female patients, from AMI onset to coronary reperfusion with resultant higher in-hospital mortality, suggesting the importance of public education, especially for elderly female people.
- © 2012 by American Heart Association, Inc.