Sex-based differences in clinical features, management, and 28-day and 7-year prognosis of first acute myocardial infarction. RESCATE II study

Cosme García-García, Lluís Molina, Isaac Subirana, Joan Sala, Jordi Bruguera, Fernando Arós, Miquel Fiol, Jordi Serra, Jaume Marrugat, Roberto Elosua

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    Abstract

    Introduction and objectives To analyze sex-based differences in clinical characteristics, management, and 28-day and 7-year prognosis after a first myocardial infarction. Methods Between 2001 and 2003, 2042 first myocardial infarction patients were consecutively registered in 6 Spanish hospitals. Clinical characteristics, management, and 28-day case-fatality were prospectively recorded. Seven-year vital status was also ascertained by data linkage with the National Mortality Index. Results The registry included 449 women and 1593 men with a first myocardial infarction. Compared with men, women were older, had a higher prevalence of hypertension and diabetes, and were more likely to receive angiotensin-converting enzyme inhibitors but were less likely to receive beta-blockers or thrombolysis. No differences were observed in use of invasive procedures. More women had non-ST-segment elevation and unclassified myocardial infarction than men (37.9% vs 31.3% and 9.8% vs 6.1%, respectively; both P<.001). Case-fatality at 28 days was similar in women and men (5.57% vs 4.46%; P=.39). After multivariate adjustment, the odds ratio of 28-day mortality for men was 1.06 (95% confidence interval: 0.49-2.27; P=.883) compared with women. After multivariate adjustment, men had higher 7-year mortality than women, hazard ratio 1.93 (95% confidence interval: 1.46-2.56; P<.001). Conclusions There are demographic and clinical differences between men and women with a first myocardial infarction. The short-term prognosis of a first myocardial infarction in this century is similar in both sexes. However, the long-term vital prognosis after a first myocardial infarction is worse in men than in women. These results are observed in both ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction events. © 2013 Sociedad Española de Cardiología. Published by Elsevier España, S.L. All rights reserved.
    Original languageEnglish
    Pages (from-to)28-35
    JournalRevista Espanola de Cardiologia
    Volume67
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2014

    Keywords

    • Acute myocardial infarction
    • Gender prognosis
    • Sex

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    García-García, C., Molina, L., Subirana, I., Sala, J., Bruguera, J., Arós, F., Fiol, M., Serra, J., Marrugat, J., & Elosua, R. (2014). Sex-based differences in clinical features, management, and 28-day and 7-year prognosis of first acute myocardial infarction. RESCATE II study. Revista Espanola de Cardiologia, 67(1), 28-35. https://doi.org/10.1016/j.recesp.2013.06.027