Impact of age and gender on in-hospital and late mortality after acute myocardial infarction:: increased early risk in younger women -: Results from the French nation-wide USIC registries
Impact of age and gender on in-hospital and late mortality after acute myocardial infarction:: increased early risk in younger women -: Results from the French nation-wide USIC registries
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DOI：
10.1093/eurheartj/ehi719
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发表时间：
2006-06-01
影响因子：
39.3
通讯作者：
Danchin, Nicolas
中科院分区：
文献类型：
--
作者：
Simon, Tabassome;Mary-Krause, Murielle;Danchin, Nicolas
目的探讨住院和出院后死亡率的性别差异是否因年龄而异。方法与结果对4347例急性心肌梗死（AMI）发病后48 h内连续住院患者的资料进行分析。患者按中位年龄（68岁）分为：1组（G1）（308名女性，30-67岁），G2（1878名男性，30-67岁），G3（860名女性，68-89岁），G4（1301名男性，68-89岁）。在这两个年龄组中，女性年龄更大，合并症更频繁，再灌注治疗率更高，抗血小板药物、受体阻滞剂和他汀类药物的使用比男性少。女性1年总死亡率较高（25% vs.男性16%，P < 0.0001）。调整后，只有年轻年龄组的妇女住院死亡率较高。(G1 vs. G2: OR = 2.2, 95%Cl = 1.3-3.8; G3 vs. G4: OR = 1.1, 95%Cl =出院后死亡风险，各年龄组均与性别无关。结论女性急性心肌梗死后1年死亡率较高的原因是年轻女性在住院头几天的死亡风险较高。为了提高年轻女性的生存机会，进一步的调查对于确定病因至关重要。
Aims To determine whether sex differences of in-hospital and after-discharge mortality differ according to the age.Methods and results Data of 4347 consecutive patients hospitalized within 48 h of the onset of acute myocardial infarction (AMI) were analysed. Patients were classified according to median age (68 years): Group 1 (G1) (308 women, 30-67 years), G2 (1878 men, 30-67 years), G3 (860 women, 68-89 years), and G4 (1301 men, 68-89 years). In both age groups, women were older, had more frequent co-morbidities, tower rate of reperfusion therapy, and received less anti-platelet agents, beta-blockers, and statins than men. The overall 1-year mortality was higher in women (25% vs. 16% in men, P < 0.0001). After adjustment, in-hospital mortality was higher only for the women in the younger age group. (G1 vs. G2: OR = 2.2, 95%Cl = 1.3-3.8; G3 vs. G4: OR = 1.1, 95%Cl = the risk of death, after hospital discharge, was no longer related to gender in any age group.Conclusion The higher 1-year mortality following AMI in women is explained by the higher risk of death in young women during the first days of hospitalization. Further investigations are crucial to determine the cause in order to improve the chance of survival in younger women.