The Influence of Gender on Outcome in Patients with First Acute Myocardial Infarction

Background -The aim of this study was to determine whether characteristics, presentation and outcome differences based on the patient's gender occur after acute myocardial infarction (AMI). Methods-By this prospective multivariate study; we assessed 500 consecutive first infarct survivors (353 men and 147 women), who were admitted to our heart center over a period of 2 years. Results-On average, women were 6.2 years older than men (P=0.030). According to multivariate analysis women were less likely than men to be smokers (p=0.0001) and more likely to have underlying hypertension (P=0.02), diabetes (P=0.041), previous angina (P=0.041), non-Qwave infarctions (P=0.019) and left ventricular ejection fraction < 40% (P=0.038). Men had significantly more 3-vessel coronary artery disease [relative risk (RR) =1.8, 95% CI, (1.212.38), P=0.02]. In-hospital mortality rate was 19% for women and 12% for men [RR =1.51, 95% CI (0.95-1.82), P=0.044); in addition, the mortality rate at 1-year follow-up was 27% for women and 15% for men [RR=1.61, 95% CI (1.04-2.51), P=0.039]. However, after an agematched analysis, we found no significant differences between men and women for in-hospital mortality. Also, our 1-year follow-up showed that the mortality rate in women was remarkably similar to the age-matched groups in men, but men had more CABG procedures in hospitalization and 1-year follow-up period [RR=2.34, 95% CI (1.35-3.0), P=0.033]. Conclusion-The age-matched mortality rate in this study was the same for men and women, excluding the greater frequency of 3-vessel involvement, advanced left main coronary disease and greater frequency of CABG operations in men.