The role of gender in the long-term prognosis of patients with myocardial infarction submitted to fibrinolytic treatment
Received 31 August 2002; accepted 25 March 2003.
Abstract
Purpose
To determine the role of gender in short- and long-term survival after a thrombolytic-treated myocardial infarction.
Methods
A total of 686 consecutive patients with ST-elevation acute myocardial infarction, admitted to a single center and treated with intravenous streptokinase, were studied prospectively and consecutively. Assessment of clinical and in-hospital variables permitted comparison of baseline characteristics and both in-hospital and long-term survival between men and women.
Results
A significantly (odds ratio=0.48, P=0.009) lower 14-day mortality rate for males (8.5%) relative to females (16%) was noted. However, this difference became non-significant after adjustment for age (odds-ratio male/female=0.62, P=0.097) or age and other variables (odds ratio=0.71, P=0.17). At the end of the follow-up (up to 12 years), survival rates for the whole population were 59.6% and 54.4% for men and women, respectively (chi-square=1.4, P=0.24); excluding in-hospital deaths, the rates were 65.1% and 64.8%, respectively (chi-square=0.21, P=0.65).
Conclusion
In the short-term follow-up, women have a significantly higher mortality relative to men in an unadjusted analysis. This difference became non-significant after adjusting for age, or age and other variables. In the long-term follow-up, sex was not correlated with prognosis.
From the Heart Institute (InCor), University of São Paulo Medical School, Brazil (J.C.N., M.A.F., C.V.S., J.A.F.R.); and Instituto de Moléstias Cardiovasculares, São José do Rio Preto, Brazil (P.R.N., S.A.C.G.)
Address correspondence to: José Carlos Nicolau, M.D., Ph.D., Aureliano Coutinho, 355–14o Andar, São Paulo 01224-020, Brazil. Tel.: 55-11-3069-5058; Fax: 55-11-3088-3809.
ABSTRACT