OBJECTIVE: To compare characteristics, management, and outcome of myocardial infarction (MI) in men and women. DESIGN: Prospective observational study. SETTING: District general hospital in southwest Scotland. PARTICIPANTS: 966 men and 597 women admitted with first MI between 1994 and 2000 with follow up to the end of 2001. RESULTS: 393 (40.7%) men and 305 (51.1%) women died during a median follow up of 3.4 years for the survivors. Univariate analysis indicated an excess mortality among women (hazard ratio (HR) 1.45, 95% confidence interval (CI) 1.25 to 1.68), which disappeared after adjustment for age, smoking, co-morbidity, previous vascular disease, diabetes, hypertension, and social deprivation (HR 1.02, 95% CI 0.87 to 1.20). There was also an excess early mortality within 30 days among women (HR 1.54, 95% CI 1.20 to 1.98), though this did not retain significance after adjustment for the same covariates (HR 1.04, 95% CI 0.79 to 1.37). Small and insignificant differences were found in the proportion of men and women receiving thrombolysis on admission and secondary prophylactic drugs at discharge, except for statins and beta blockers, which were respectively more (adjusted odds ratio 1.48, 95% CI 1.10 to 1.98) and less (adjusted odds ratio 0.78, 95% CI 0.60 to 1.00) commonly prescribed to women. CONCLUSION: Results suggest that the poorer outcome for women after MI reported in other studies may reflect sex bias in management as well as differences in age and co-morbidity and support the view that if women have access to the same quality of care as men then survival will be the same.
OBJECTIVE: To compare characteristics, management, and outcome of myocardial infarction (MI) in men and women. DESIGN: Prospective observational study. SETTING: District general hospital in southwest Scotland. PARTICIPANTS: 966 men and 597 women admitted with first MI between 1994 and 2000 with follow up to the end of 2001. RESULTS: 393 (40.7%) men and 305 (51.1%) women died during a median follow up of 3.4 years for the survivors. Univariate analysis indicated an excess mortality among women (hazard ratio (HR) 1.45, 95% confidence interval (CI) 1.25 to 1.68), which disappeared after adjustment for age, smoking, co-morbidity, previous vascular disease, diabetes, hypertension, and social deprivation (HR 1.02, 95% CI 0.87 to 1.20). There was also an excess early mortality within 30 days among women (HR 1.54, 95% CI 1.20 to 1.98), though this did not retain significance after adjustment for the same covariates (HR 1.04, 95% CI 0.79 to 1.37). Small and insignificant differences were found in the proportion of men and women receiving thrombolysis on admission and secondary prophylactic drugs at discharge, except for statins and beta blockers, which were respectively more (adjusted odds ratio 1.48, 95% CI 1.10 to 1.98) and less (adjusted odds ratio 0.78, 95% CI 0.60 to 1.00) commonly prescribed to women. CONCLUSION: Results suggest that the poorer outcome for women after MI reported in other studies may reflect sex bias in management as well as differences in age and co-morbidity and support the view that if women have access to the same quality of care as men then survival will be the same.
Authors: K MacIntyre; S Stewart; S Capewell; J W Chalmers; J P Pell; J Boyd; A Finlayson; A Redpath; H Gilmour; J J McMurray Journal: J Am Coll Cardiol Date: 2001-09 Impact factor: 24.094
Authors: A Bannerman; K Hamilton; C Isles; H Barrington; B Donaldson; L Lockhart; K McMeeken; J Mark; J Norrie Journal: Scott Med J Date: 2001-06 Impact factor: 0.729
Authors: Tobias Heer; Rudolf Schiele; Steffen Schneider; Anselm K Gitt; Harm Wienbergen; Martin Gottwik; Ulf Gieseler; Thomas Voigtländer; Karl E Hauptmann; Stefan Wagner; Jochen Senges Journal: Am J Cardiol Date: 2002-03-01 Impact factor: 2.778
Authors: B Hanratty; D A Lawlor; M B Robinson; R J Sapsford; D Greenwood; A Hall Journal: J Epidemiol Community Health Date: 2000-12 Impact factor: 3.710
Authors: Fei Gao; Carolyn Su Ping Lam; Ling Ling Sim; Tian Hai Koh; David Foo; Hean Yee Ong; Khim Leng Tong; Huay Cheem Tan; David Machin; Kok Seng Wong; Mark Yan Yee Chan; Terrance Siang Jin Chua Journal: BMC Public Health Date: 2015-03-31 Impact factor: 3.295