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Circulation, Vol 83, 484-491, Copyright © 1991 by American Heart Association
P Greenland, H Reicher-Reiss, U Goldbourt and S Behar
We determined in-hospital and 1-year prognoses after acute myocardial
infarction (MI) in 5,839 consecutive patients derived from 14 of 21
coronary care units in Israel during 1981-1983. Age-adjusted in- hospital
mortality was 23.1% in 1,524 women and 15.7% in 4,315 men (p less than
0.0005). One-year age-adjusted mortality rates in patients surviving
hospitalization were 11.8% in women and 9.3% in men (p = 0.03). Cumulative
age-adjusted 1-year mortality rates were 31.8% in women and 23.1% in men (p
less than 0.0005). Relative odds of mortality, covariate-adjusted for major
prognostic factors that included age, prior MI, congestive heart failure,
and infarct location by electrocardiogram, indicated that female gender was
independently and significantly associated with increased mortality both
during hospitalization (relative odds, 1.72; 95% confidence interval, 1.45-
2.04) and at 1 year after discharge (relative odds, 1.32; 95% confidence
interval, 1.05-1.66). In separate multivariate analyses for each gender, a
major factor that emerged as a predictor of outcome in women, but not in
men, was a reported history of diabetes mellitus, both for in-hospital
mortality and for 1-year mortality. However, even in the nondiabetics in
this population, female gender was a significant, independent predictor of
in-hospital mortality. The findings of the present study substantiate that
women fare worse than men after suffering an acute MI, that increased age
does not fully account for the increased mortality in women, and that
diabetic women are at particularly high risk once MI has occurred.
ARTICLES
In-hospital and 1-year mortality in 1,524 women after myocardial infarction. Comparison with 4,315 men
Neufeld Cardiac Research Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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