Myocardial infarction: women were less likely to die than men within 30 days.

Clinical bottom line (level 2b)

  1. One in two patients with a myocardal infarction died within 30 days.
  2. Women were less likely to die than men within 30 days, but not at one year.
MacIntyre et al: J Am Coll Cardiol 2001; 38 : 729-735
Expires March 2004

The study

Retrospective cohort study with objective outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: all hospitals, Scotland

201114 patients (aged mean 70, 56% male) first myocardial infarction (no previous MI within 5 years)

Factors studied:
  • Age, socioeconomic deprevation, comorbidity
  • female
Multiple logisitic regression analysis was used to adjust for confounding factors.

100 followed for 12 months
Outcomes studied:
  • death

    The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)    		 NNF
    (95% CI)
    death 30 days 110153/201114 54.8%
    (54.6% to 55.0%)    		 2
    (2 to 2)

    prognostic factor for
    death     		time to outcome control rate (%) adjusted OR
    (95% CI)    		 NNF+
    (95% CI)
    female 30 days 57447/113281
    (50.7%)     		0.90
    (0.89 to 0.93)     		-38
    (-55 to -34)
     
    • Gender was not an independent predictor of one year survival.

    Comments

    1. Women were on average 7 years older than men. This accounted for the higher unadjusted mortality rate noted in the first 30 days.
    2. Women aged < 55 had worse outcomes in hospitals than men of similar ages, but women > 65 had better ones.
     

    Citation

    1. MacIntyre K, Stewart S, Capewell S, et al: gender and survival: a population-based study of 201,114 men and women following a first myocardial infarction. J Am Coll Cardiol 2001; 38 : 729-735
    Search Terms: from ACP Journal Club
    Contributor: Chris Ball, March 2002
    Reviewer:

    Clinical Question.
    Patient first myocardial infarction
    Intervention or Exposure age, sex
    Outcome death