Causes of higher in-hospital mortality in women than in men after acute myocardial infarction

James Stephen Jenkins, Greg C. Flaker, Barbie Nolte, Leigh Ann Price, Don Morris, James Kurz, Gregory F. Petroski

Research output: Contribution to journalArticlepeer-review

Abstract

Clinical, laboratory and cardiac catheterization parameters were reviewed in 355 men and 155 women hospitalized at a tertiary care referral center between February 1987 and December 1991 to analyze why women have a higher in-hospital mortality rate than do men after acute myocardial infarction. Hospital mortality was 21.4% in women and 12.1% in men (p = 0.007). In comparison with men, women were older (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 regression analysis revealed 5 variables predictive of hospital mortality: age >65 years, diabetes, shock, non-Q-wave infarction, and not undergoing cardiac catheterization. Gender was of borderline significance in predicting hospital mortality. Cardiac catheterization, performed in 88% of women and 87% of men, showed similar rates of 1-, 2- and 3-vessel disease, and similar characteristics of the infarction-related artery. The differences in hospital mortality between men and women are due to a combination of pre- and in-hospitalization factors in women. The excess mortality is not due to differences in disease severity as evaluated by cardiac catheterization information.

Original languageEnglish (US)
Pages (from-to)319-322
Number of pages4
JournalThe American journal of cardiology
Volume73
Issue number5
DOIs
StatePublished - Feb 15 1994
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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