A comparison of the early outcome of acute myocardial infarction in women and men. The Third International Study of Infarct Survival Collaborative Group.
A comparison of the early outcome of acute myocardial infarction in women and men. The Third International Study of Infarct Survival Collaborative Group.
复制标题
女性和男性急性心肌梗死早期结局的比较。
DOI：
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发表时间：
1998
影响因子：
158.5
通讯作者：
T. Moccetti
中科院分区：
文献类型：
--
作者：
R. Malacrida;M. Genoni;A. Maggioni;V. Spataro;S. Parish;Alison Palmer;R. Collins;T. Moccetti
背景
在以前的研究中，对急性心肌梗死后死亡率和主要发病率的未经调整的比较通常表明，女性的预后比男性更差。需要进行更大规模的研究，对共存条件进行更全面的调整，以确定这种差异是由研究女性的年龄较大还是由其他不利预后因素的存在造成的，还是两者兼而有之。
方法
作为第三次国际心肌梗死存活研究(ISIS-3)的一部分，收集了9600名女性和26480名男性疑似急性心肌梗死患者的信息，这些患者在0至35天内死亡，并在住院至第35天期间发生重大临床事件，这些患者被认为有明确的纤溶治疗指征。我们比较了女性和男性的结果，首先没有调整，然后调整了年龄，最后通过多元Logistic回归分析调整了其他记录的基线特征。
结果
与男性相比，女性死亡的未调整优势比为1.73(95%可信区间为1.61至1.86)。女性明显比男性年龄大，在调整年龄后，优势比显著降低至1.20(95%可信区间，1.11至1.29)。对基线临床特征的其他差异进行调整后，优势比进一步降至1.14(95%可信区间为1.05至1.23)。通过调整，女性在其他重大临床事件中的过度行为通常也会以类似的程度减少。
结论
女性与疑似急性心肌梗死后的早期死亡率和发病率至多只有很小的独立关联。
BACKGROUND
In previous studies, unadjusted comparisons of mortality and major morbidity after acute myocardial infarction have generally indicated that women have a poorer outcome than men. Much larger studies are needed, with more complete adjustment for coexisting conditions, to determine whether this difference is explained by the older age of the women studied or by the presence of other unfavorable prognostic factors, or both.
METHODS
As part of the Third International Study of Infarct Survival (ISIS-3), information was collected on deaths during days 0 to 35 and on major clinical events during hospitalization up to day 35 for 9600 women and 26,480 men with suspected acute myocardial infarction who were considered to have a clear indication for fibrinolytic therapy. We compared the outcome among women and men, first without adjustment, then with adjustment for age, and finally with adjustment for other recorded baseline characteristics by means of multiple logistic regression.
RESULTS
The unadjusted odds ratio for death among women as compared with men was 1.73 (95 percent confidence interval, 1.61 to 1.86). The women were significantly older than the men, and after adjustment for age the odds ratio was reduced markedly to 1.20 (95 percent confidence interval, 1.11 to 1.29). Adjustment for other differences in base-line clinical features further reduced the odds ratio to 1.14 (95 percent confidence interval, 1.05 to 1.23). Excesses in other major clinical events among women were generally reduced to a similar extent by adjustment.
CONCLUSIONS
It seems likely that there is at most only a small independent association between female sex and early mortality and morbidity after suspected acute myocardial infarction.
影响因子：
158.5
作者：
AYANIAN, JZ;EPSTEIN, AM
通讯作者：
EPSTEIN, AM