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(Circulation. 1995;92:1133-1140.)
© 1995 American Heart Association, Inc.
Articles |
Influence of Sex on the Short-term Outcome of Elderly Patients With a First Acute Myocardial Infarction
From the Department of Cardiology, Hospital General Universitario "Gregorio Marañón," Madrid, Spain.
Correspondence to Héctor Bueno, MD, Department of Cardiology, Hospital General Universitario "Gregorio Marañón," Dr Esquerdo, 46, 28007 Madrid, Spain.
Background Sex seems to affect the course of acute myocardial infarction (AMI) in the general population. Although the epidemiological importance of female sex among patients with AMI is more important from the sixth decade of life, little is known about the impact of sex on the outcome of AMI in the elderly.
Methods and Results To determine the differences between sexes in
the outcome of AMI in the elderly, we compared the clinical history and
evolution of 204 consecutive patients (99 men, 105 women) 
75 years of
age admitted with a first AMI. Women had a higher prevalence
(P<.01) of hypertension (60% versus 32%) and diabetes
(41% versus 18%), whereas men were more frequently smokers (41%
versus 4%, P<.0001); these factors were associated with
higher rates of congestive heart failure. Women showed lower ejection
fractions and higher rates of congestive heart failure (odds ratio
[OR], 2.32; 95% CI, 1.32 to 4.12) and shock (OR, 2.78; 95% CI, 1.29
to 6.40). Mortality rate was higher in women (40% versus 23%,
P=.01; OR, 2.29; 95% CI, 1.26 to 4.26); however, sex was
excluded as an independent predictor of in-hospital mortality in every
regression model tested (OR, 0.75; 95% CI, 0.25 to 2.21).
Conclusions After a first AMI, elderly women experience a more complicated hospital course than men. The increase in mortality risk seems to be related to the impact of cardiovascular risk factors on left ventricular function more than to sex itself.
Key Words: myocardial infarction • heart failure • mortality • aging • women
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