Gender-Related Trends in Mortality in Hospitalized Men and Women after Myocardial Infarction between 1985 and 2008: Equal Benefit for Women and Men
Background—We aimed to study gender-related differences in temporal trends in short- and long-term mortality from 1985 to 2008 in patients hospitalized for acute myocardial infarction (MI).
Methods and Results—We included a total of 14,434 consecutive patients admitted to our Intensive Coronary Care Unit between 1985 and 2008 for MI. A total of 4,028 (28%) patients were women. Women were more likely to present with a higher risk profile and equally likely to receive pharmacological and invasive reperfusion therapy compared to men. Women had a higher unadjusted mortality rate at 30-days (OR 1.3, 95%CI: 1.1-1.5) and during 20-years (HR 1.1, 95%CI: 1.0-1.2) follow-up. After adjustment for baseline characteristics, 30-day mortality was equal (adjusted OR 1.0, 95%CI: 0.85-1.2), but the hazard for 20-year mortality was lower (adjusted HR 0.77, 95%CI: 0.66-0.90) in women compared to men. For 30-day mortality, there was no significant interaction between gender and age, diagnosis or diabetes. Survival improved between 1985 and 2008. Temporal mortality reductions between 1985 and 2008 were at least as high in women compared to men with MI, both for 30-day mortality and long-term mortality hazard.
Conclusions—The fact that adjusted mortality rates for both the men and women treated for myocardial infarction in an Intensive Coronary Care Unit were similar and declined markedly over a 24-year period suggests that both sexes benefit from the evidence-based therapies that have been developed and implemented during this time period.
- Received April 24, 2012.
- Accepted September 14, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited