Gender differences in health-related quality of life among postmyocardial infarction patients: brief report. CAST Investigators. Cardiac Arrhythmia Suppression Trials.

Heart disease is the leading cause of death among women in the United States. The prognosis for heart disease is worse for women than for men. Also, although women are less likely than men to initially present with a myocardial infarction (MI), they are more likely to die following an MI. A number of factors have been identified that partially account for the gender difference in post-MI morbidity and mortality. However, limited data are available on the sex differences in clinical, psychosocial, and demographic factors that may combine to explain the poorer prognosis for women following an acute MI. The Cardiac Arrhythmia Suppression Trials collected detailed demographic, clinical, and psychosocial data on 2,043 men and 448 women following acute MIs. Analyses indicate that women had a worse clinical, socioeconomic, and psychosocial profile than did men. In addition, significant differences in psychosocial profiles persisted after controlling for demographic and clinical data, suggesting that women presenting with MIs have a cluster of complex factors that put them at high risk for morbidity and mortality following an MI. Future longitudinal studies that include adequate numbers of women as well as reliable assessments of both clinical and psychological variables are needed to better understand the factors that influence the poor prognosis for women with coronary heart disease.