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Eur J Epidemiol. 2012 Nov;27(11):847-55. doi: 10.1007/s10654-012-9712-8. Epub 2012 Jul 10.

Sex-related differences in prognosis after myocardial infarction: changes from 1978 to 2007.

Author information

1
Program of Research in Inflammatory and Cardiovascular Disorders (RICAD), Cardiovascular Epidemiology and Genetics, IMIM, 88 Dr Aiguader Street, 08003, Barcelona, Spain.

Abstract

Women with myocardial infarction (MI) have shown a 28-day survival disadvantage compared with men. However, results were less consistent when considering long-term mortality in 28-day survivors. The aim was to estimate the trends for sex-related differences in the three endpoints considered for this study: (1) 28-day mortality or severe ventricular dysfunction (acute pulmonary oedema or cardiogenic shock) during the hospital stay, (2) 28-day mortality and (3) two-year cardiovascular mortality or non-fatal MI in 28-day survivors after a first MI. A cohort of 3,982 consecutive patients with first Q-wave MI admitted to a university tertiary reference hospital between 1978 and 2007 was followed for 2 years. Short-term prognosis improved in women over the studied period; similar rates were observed in both sexes in the 2000s. After adjusting for age, co-morbidities and anterior location of MI, female sex had an odds ratio=1.71 (95% confidence interval [CI] 1.34-2.17) of short-term severe MI or death over the studied period. Overall, sex differences in long-term prognosis remained similar over the studied period (hazard ratio=1.40; 95% CI 1.02-1.91). In conclusion, short-term prognosis improved over the past 30 years for first Q-wave MI patients, becoming similar for both men and women in the most recent decade. Long-term prognosis did not improve in either men or women, indicating that secondary prevention should be reinforced to achieve consistent reductions in the number of cardiovascular events.

PMID:
22777715
DOI:
10.1007/s10654-012-9712-8
[Indexed for MEDLINE]

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