Sex-related differences in prognosis after myocardial infarction: changes from 1978 to 2007

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• 作者：María Grau (1)
  Cristina Sala (3) (4)
  Joan Sala (5)
  Rafael Masia (5)
  Joan Vila (1)
  Isaac Subirana (1) (2)
  Rafel Ramos (6) (7)
  Roberto Elosua (1) (2)
  Ramón Brugada (7)
  Jaume Marrugat (1)
  
• 关键词：Cohort study ; Coronary disease ; Epidemiology ; Myocardial infarction ; Prognosis ; Sex
• 刊名：European Journal of Epidemiology
• 出版年：2012
• 出版时间：November 2012
• 年：2012
• 卷：27
• 期：11
• 页码：847-855
• 全文大小：305KB
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• 作者单位：María Grau (1)
  Cristina Sala (3) (4)
  Joan Sala (5)
  Rafael Masia (5)
  Joan Vila (1)
  Isaac Subirana (1) (2)
  Rafel Ramos (6) (7)
  Roberto Elosua (1) (2)
  Ramón Brugada (7)
  Jaume Marrugat (1)
  
  1. Program of Research in Inflammatory and Cardiovascular Disorders (RICAD), Cardiovascular Epidemiology and Genetics, IMIM, 88 Dr Aiguader Street, 08003, Barcelona, Spain
  3. Public Health and the Methodology of Biomedical Research, Universitat Autònoma de Barcelona, Barcelona, Spain
  4. The Consell de Cent Primary Care Center, àmbit d’Atenció Primària de Barcelona Ciutat, Barcelona, Spain
  5. Cardiology Department, Hospital Josep Trueta, Girona, Spain
  2. CIBER Epidemiology and Public Health, Barcelona, Spain
  6. Research Unit, àmbit d’Atenció Primària de Girona, IDIAP JGol, Institut Català de la Salut, Girona, Spain
  7. Facultat de Medicina, Universitat de Girona, Girona, Spain
  
• ISSN：1573-7284

文摘

Women with myocardial infarction (MI) have shown a 28-day survival disadvantage compared with men. However, results were less consistent when considering long-term mortality in 28-day survivors. The aim was to estimate the trends for sex-related differences in the three endpoints considered for this study: (1) 28-day mortality or severe ventricular dysfunction (acute pulmonary oedema or cardiogenic shock) during the hospital stay, (2) 28-day mortality and (3) two-year cardiovascular mortality or non-fatal MI in 28-day survivors after a first MI. A cohort of 3,982 consecutive patients with first Q-wave MI admitted to a university tertiary reference hospital between 1978 and 2007 was followed for 2?years. Short-term prognosis improved in women over the studied period; similar rates were observed in both sexes in the 2000s. After adjusting for age, co-morbidities and anterior location of MI, female sex had an odds ratio?=?1.71 (95?% confidence interval [CI] 1.34-.17) of short-term severe MI or death over the studied period. Overall, sex differences in long-term prognosis remained similar over the studied period (hazard ratio?=?1.40; 95?% CI 1.02-.91). In conclusion, short-term prognosis improved over the past 30?years for first Q-wave MI patients, becoming similar for both men and women in the most recent decade. Long-term prognosis did not improve in either men or women, indicating that secondary prevention should be reinforced to achieve consistent reductions in the number of cardiovascular events.