STONY BROOK, N.Y., November 13, 2006 – A study of 9,015 patients who underwent primary angioplasty for acute myocardial infarction (AMI) in New York State revealed that the in-hospital mortality rate was twofold higher in women than in men and that the female gender is an independent predictor of mortality in patients younger than age 75. David L. Brown, M.D, Professor and Chief of Cardiovascular Medicine and Co-Director of the Heart Center at Stony Brook University Medical Center and his colleague Jeffrey S. Berger, M.D., Division of Cardiovascular Medicine, Duke University School of Medicine, Durham, N.C., reported these findings in the November 1 online edition of the American Journal of Cardiology.
Previous studies have demonstrated significant interaction between gender and age as related to mortality after medically treated AMI. Dr. Brown’s study, however, was designed to determine whether a gender-age interaction exists for AMI patients treated exclusively with primary angioplasty.
“Two significant findings emerged from our study,” said Dr. Brown. “First, women had an increased unadjusted in-hospital mortality compared to men that was no longer significant after adjustment for demographics, co-morbidities, and clinical presentation. Second, when examining the gender-age interaction, there was a marked difference in outcome after AMI for women versus men when stratified by age,” explained Dr. Brown. He added that women younger than age 75 demonstrated a significantly higher risk of mortality than men, but for patients older than age 75, there was no difference in mortality between the two genders.
Of the total patients, 2,619 (29%) were women. The overall in-hospital mortality rate for women was 6.7%, verses 3.4% in men. In patients younger than age 75, in-hospital mortality rates for was 4.8% but only 2.6% in men. In addition, of those patients younger than age 75, women had more conditions contributing to heart disease, such as hypertension, diabetes, stroke, and peripheral vascular disease.
Dr. Brown said some limitations of the study should be kept in mind when interpreting the results. For example, the analysis involved only a small subset of patients who underwent primary angioplasty in New York State, and it is unknown whether the trends in survival rates among women and men in the study would continue after discharge from the hospital.