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Heart. 2015 Mar;101(5):349-55. doi: 10.1136/heartjnl-2014-306456. Epub 2014 Dec 15.

Age-specific gender differences in early mortality following ST-segment elevation myocardial infarction in China.

Author information

1
National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
2
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, USA.
3
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, USA Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
4
Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA Colorado Cardiovascular Outcomes Research Consortium, Denver, Colorado, USA.
5
Health Outcomes Research, Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (JAS), Kansas City, Missouri, USA.
6
Center for Wellness & Prevention Research and Miami Cardiovascular Institute, Baptist Health South Florida, Miami, Florida, USA.
7
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, USA Yale School of Public Health, New Haven, Connecticut, USA.
8
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, USA Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA.

Abstract

OBJECTIVE:

To assess whether younger, but not older, women in China have higher in-hospital mortality following ST-Segment Elevation Myocardial Infarction (STEMI) compared with men, and whether this relationship varied over the last decade or across rural/urban areas.

METHODS:

We analysed a nationally representative sample of 11 986 patients with STEMI from 162 Chinese hospitals in 2001, 2006 and 2011, in the China PEACE-Retrospective AMI Study and compared in-hospital mortality between women and men with gender-age interactions in multivariable models.

RESULTS:

The overall in-hospital mortality rate was higher in women compared with men (17.2% vs 9.1%, p<0.0001; unadjusted OR 2.07, 95% CI 1.85 to 2.33). The unadjusted OR for mortality in women, compared with men, was 2.20 (95% CI 1.59 to 3.04), 2.21 (95% CI 1.74 to 2.79), 1.37 (95% CI 1.15 to 1.65) and 1.25 (95% CI 0.97 to 1.63) for ages <60, 60-69, 70-79 and ≥80 years, respectively. After adjustment for patient characteristics, hospital characteristics and year of study, the OR for mortality comparing women with men was 1.69 (95% CI 1.01 to 2.83), 1.64 (95% CI 1.24 to 2.19), 1.15 (95% CI 0.90 to 1.46) and 0.82 (95% CI 0.60 to 1.11) for ages <60, 60-69, 70-79 and ≥80 years, respectively. The gender-age interaction for mortality was statistically significant (p=0.009), even after adjustment for a wide range of confounders, and did not vary over time or across rural/urban areas.

CONCLUSIONS:

Among a Chinese population with STEMI, gender differences in early mortality were age-dependent and greatest in the younger groups <70 years of age.

TRIAL REGISTRATION NUMBER:

http://www.clinicaltrials.gov (NCT01624883).

KEYWORDS:

CORONARY ARTERY DISEASE

PMID:
25510395
PMCID:
PMC4453015
DOI:
10.1136/heartjnl-2014-306456
[Indexed for MEDLINE]
Free PMC Article
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