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(Circulation. 2007;115:823-826.)
© 2007 American Heart Association, Inc.

Editorial

Gender Differences in the Treatment for Acute Myocardial Infarction

Bias or Biology?

R. David Anderson, MD; Carl J. Pepine, MD

From the Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville.

Correspondence to Carl J. Pepine, MD, Division of Cardiovascular Medicine, University of Florida College of Medicine, 1600 SW Archer Rd, Box 100277, Gainesville, FL 32610–0277.

Key Words: Editorials • angioplasty • coronary disease • sex • myocardial infarction • stents • women

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Accumulating evidence over the last several decades regarding the treatment and outcomes for coronary artery disease reveals disparities that have a clear relationship to gender. It had previously been thought that these differences were related to gender bias in physicians’ approach to treatment; thus, the term Yentl syndrome was coined in 1991.¹ As the volume of literature expanded and clinical studies included more women, it became clear that outcomes after treatment for coronary artery disease, particularly acute myocardial infarction, were different for women compared with men. Women have a well-documented higher mortality after acute myocardial infarction.² Much of this disparity has been attributed to differences in age and attendant comorbidities. Female patients with coronary artery disease typically are older, have a higher prevalence of risk factors, and have a lower functional status than their male counterparts.^3,4 Additionally, women appear to be at higher risk than men when diabetes, hypertriglyceridemia, and metabolic syndrome are present. The underuse of revascularization procedures in women has been suggested as an explanation, but it has not been uniformly demonstrated to explain increases in mortality. Some studies have suggested a link to less aggressive hospital care of female patients, including the underuse of revascularization, as an explanation for their increased mortality.⁵ Other studies have indicated age and comorbidity as the primary factors leading to mortality differences.⁶ Still other studies suggest no evidence of undertreatment.^7,8

Article p 833

Gender differences in the clinical outcome of patients with acute myocardial infarction may be explained in part by the . . . [Full Text of this Article]

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