Rachel P Dreyer1, Yongfei Wang2, Kelly M Strait2, Nancy P Lorenze2, Gail D'Onofrio2, Héctor Bueno2, Judith H Lichtman2, John A Spertus2, Harlan M Krumholz2. 1. From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.). rachel.dreyer@yale.edu. 2. From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).
Abstract
BACKGROUND: Despite the excess risk of mortality in young women (≤55 years of age) after acute myocardial infarction (AMI), little is known about young women's health status (symptoms, functioning, quality of life) during the first year of recovery after an AMI. We examined gender differences in health status over time from baseline to 12 months after AMI. METHODS AND RESULTS: A total of 3501 AMI patients (67% women) 18 to 55 years of age were enrolled from 103 US and 24 Spanish hospitals. Data were obtained by medical record abstraction and patient interviews at baseline hospitalization and 1 and 12 months after AMI. Health status was measured by generic (Short Form-12) and disease-specific (Seattle Angina Questionnaire) measures. We compared health status scores at all 3 time points and used longitudinal linear mixed-effects analyses to examine the independent effect of gender, adjusting for time and selected covariates. Women had significantly lower health status scores than men at each assessment (all P values <0.0001). After adjustment for time and all covariates, women had Short Form-12 physical/mental summary scores that were -0.96 (95% confidence interval [CI], -1.59 to -0.32) and -2.36 points (95% CI, -2.99 to -1.73) lower than those of men, as well as worse Seattle Angina Questionnaire physical limitations (-2.44 points lower; 95% CI, -3.53 to -1.34), more angina (-1.03 points lower; 95% CI, -1.98 to -0.07), and poorer quality of life (-3.51 points lower; 95% CI, -4.80 to -2.22). CONCLUSION: Although both genders recover similarly after AMI, women have poorer scores than men on all health status measures, a difference that persisted throughout the entire year after discharge.
RCT Entities:
BACKGROUND: Despite the excess risk of mortality in young women (≤55 years of age) after acute myocardial infarction (AMI), little is known about young women's health status (symptoms, functioning, quality of life) during the first year of recovery after an AMI. We examined gender differences in health status over time from baseline to 12 months after AMI. METHODS AND RESULTS: A total of 3501 AMI patients (67% women) 18 to 55 years of age were enrolled from 103 US and 24 Spanish hospitals. Data were obtained by medical record abstraction and patient interviews at baseline hospitalization and 1 and 12 months after AMI. Health status was measured by generic (Short Form-12) and disease-specific (Seattle Angina Questionnaire) measures. We compared health status scores at all 3 time points and used longitudinal linear mixed-effects analyses to examine the independent effect of gender, adjusting for time and selected covariates. Women had significantly lower health status scores than men at each assessment (all P values <0.0001). After adjustment for time and all covariates, women had Short Form-12 physical/mental summary scores that were -0.96 (95% confidence interval [CI], -1.59 to -0.32) and -2.36 points (95% CI, -2.99 to -1.73) lower than those of men, as well as worse Seattle Angina Questionnaire physical limitations (-2.44 points lower; 95% CI, -3.53 to -1.34), more angina (-1.03 points lower; 95% CI, -1.98 to -0.07), and poorer quality of life (-3.51 points lower; 95% CI, -4.80 to -2.22). CONCLUSION: Although both genders recover similarly after AMI, women have poorer scores than men on all health status measures, a difference that persisted throughout the entire year after discharge.
Authors: J A Spertus; J A Winder; T A Dewhurst; R A Deyo; J Prodzinski; M McDonell; S D Fihn Journal: J Am Coll Cardiol Date: 1995-02 Impact factor: 24.094
Authors: Christopher B Granger; Robert J Goldberg; Omar Dabbous; Karen S Pieper; Kim A Eagle; Christopher P Cannon; Frans Van De Werf; Alvaro Avezum; Shaun G Goodman; Marcus D Flather; Keith A A Fox Journal: Arch Intern Med Date: 2003-10-27
Authors: Charles F Emery; David J Frid; Tilmer O Engebretson; Angelo A Alonzo; Anne Fish; Amy K Ferketich; Nancy R Reynolds; Jean-Pierre L Dujardin; JoAnn E Homan; Stephen L Stern Journal: Psychosom Med Date: 2004 Mar-Apr Impact factor: 4.312
Authors: Rachel P Dreyer; Kumar Dharmarajan; Kevin F Kennedy; Philip G Jones; Viola Vaccarino; Karthik Murugiah; Sudhakar V Nuti; Kim G Smolderen; Donna M Buchanan; John A Spertus; Harlan M Krumholz Journal: Circulation Date: 2017-02-07 Impact factor: 29.690
Authors: Rachel P Dreyer; Xiao Xu; Weiwei Zhang; Xue Du; Kelly M Strait; Maggie Bierlein; Emily M Bucholz; Mary Geda; James Fox; Gail D'Onofrio; Judith H Lichtman; Héctor Bueno; John A Spertus; Harlan M Krumholz Journal: Circ Cardiovasc Qual Outcomes Date: 2016-02
Authors: Kelly C Epps; Elizabeth M Holper; Faith Selzer; Helen A Vlachos; Sarah K Gualano; J Dawn Abbott; Alice K Jacobs; Oscar C Marroquin; Srihari S Naidu; Peter W Groeneveld; Robert L Wilensky Journal: Circ Cardiovasc Qual Outcomes Date: 2016-02
Authors: Rachel P Dreyer; Kumar Dharmarajan; Angela F Hsieh; John Welsh; Li Qin; Harlan M Krumholz Journal: Circ Cardiovasc Qual Outcomes Date: 2017-05
Authors: Yuan Lu; Shengfan Zhou; Rachel P Dreyer; Michael Caulfield; Erica S Spatz; Mary Geda; Nancy P Lorenze; Peter Herbert; Gail D'Onofrio; Elizabeth A Jackson; Judith H Lichtman; Héctor Bueno; John A Spertus; Harlan M Krumholz Journal: Am Heart J Date: 2016-10-03 Impact factor: 4.749
Authors: Leslee J Shaw; Joe X Xie; Lawrence M Phillips; Abhinav Goyal; Harmony R Reynolds; Daniel S Berman; Michael H Picard; Balram Bhargava; Gerard Devlin; Bernard R Chaitman Journal: Heart Asia Date: 2016-06-01
Authors: Melissa M Farmer; Maggie A Stanislawski; Mary E Plomondon; Bevanne Bean-Mayberry; Nataria T Joseph; Lauren E Thompson; Jessica L Zuchowski; Stacie L Daugherty; Elizabeth M Yano; P Michael Ho Journal: J Womens Health (Larchmt) Date: 2017-05-12 Impact factor: 2.681
Authors: Ali Shafiq; Suzanne V Arnold; Kensey Gosch; Faraz Kureshi; Tracie Breeding; Philip G Jones; John Beltrame; John A Spertus Journal: Am Heart J Date: 2016-02-27 Impact factor: 4.749
Authors: Yuan Lu; Shengfan Zhou; Rachel P Dreyer; Erica S Spatz; Mary Geda; Nancy P Lorenze; Gail D'Onofrio; Judith H Lichtman; John A Spertus; Paul M Ridker; Harlan M Krumholz Journal: Circ Cardiovasc Qual Outcomes Date: 2017-02-22
Authors: Ryan Saelee; Viola Vaccarino; Samaah Sullivan; Muhammad Hammadah; Amit Shah; Kobina Wilmot; Naser Abdelhadi; Lisa Elon; Pratik Pimple; Belal Kaseer; Oleksiy Levantsevych; J D Bremner; Tené T Lewis Journal: J Psychosom Res Date: 2019-07-19 Impact factor: 3.006