CAUSES OF HIGHER IN-HOSPITAL MORTALITY IN WOMEN THAN IN MEN AFTER ACUTE MYOCARDIAL-INFARCTION

Citation
Js. Jenkins et al., CAUSES OF HIGHER IN-HOSPITAL MORTALITY IN WOMEN THAN IN MEN AFTER ACUTE MYOCARDIAL-INFARCTION, The American journal of cardiology, 73(5), 1994, pp. 319-322
Citations number
23
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System
ISSN journal
0002-9149
Volume
73
Issue
5
Year of publication
1994
Pages
319 - 322
Database
ISI
SICI code
0002-9149(1994)73:5<319:COHIMI>2.0.ZU;2-J
Abstract
Clinical, laboratory and cardiac catheterization parameters were revie wed in 355 men and 155 women hospitalized at a tertiary care referral center between February 1987 and December 1998 to analyze why women ha ve a higher in-hospital mortality rate than do men after acute myocard ial infarction. Hospital mortality was 21.4% to women and 12.1% in men (p = 0.007). In comparison with men, women were elder (63.3 +/- 11.9 vs 60.5 +/- 12.6 years; p = 0.023), had more systemic hypertension (46 .5 vs 34.4%; p = 0.001) and higher serum total cholesterol levels (211 +/- 51 vs 197 +/- 49 mg/dl; p = 0.0015), sought medical care later (8 .9 vs 5.3 hours; p = 0.026), were referred later (47.7 vs 43.7 hours; p = 0.063) and had more shock (34.8 vs 24.2%; p = 0.013); Logistic reg ression analysis revealed 5 variables predictive of hospital mortality : age >65 years, diabetes, shock, non-Q-wave infarction, and not under going cardiac catheterization. Gender was of borderline significance i n predicting hospital mortality. Cardiac catheterization, performed in 88% of women and 87% of men, showed similar rates of 1-, 2- and 3-ves sel disease, and similar characteristics of the infarction-related art ery. The differences in hospital mortality between men and women are d ue to a combination of pre- and in-hospitalization factors in women. T he excess mortality is not due to differences in disease severity as e valuated by cardiac catheterization information.