Sex differences in mortality after acute myocardial infarction: changes from 1994 to 2006.
Sex differences in mortality after acute myocardial infarction: changes from 1994 to 2006.
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DOI：
10.1001/archinternmed.2009.332
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发表时间：
2009-10-26
影响因子：
--
通讯作者：
Canto, John
中科院分区：
文献类型：
--
作者：
Vaccarino, Viola;Parsons, Lori;Peterson, Eric D.;Rogers, William J.;Kiefe, Catarina I.;Canto, John
先前的研究表明，55 岁以下的女性在急性心肌梗死 (MI) 后的医院死亡率高于同龄男性。我们研究了近年来这种死亡率差异是否有所减少。我们调查了 1994 年 6 月 1 日至 2006 年 12 月 31 日期间按性别和年龄划分的医院 MI 病死率的时间趋势。研究人群包括国家心肌梗死登记处确诊为 MI 的 916 380 名患者。 1994 年至 2006 年间，所有患者的院内死亡率均显着下降，但女性的降幅高于男性。与 1994 年相比，2006 年死亡率下降幅度最大的是 55 岁以下的女性（52.9%），最低的是 55 岁以下的男性（33.3%）。在 55 岁以下的患者中，女性死亡率的绝对下降幅度是男性的 3 倍（2.7% vs 0.9%）。因此，与 1994-1995 年（未经调整的优势比，1.93；95% 置信区间，1.67-2.24）相比，2004-2006 年（未经调整的优势比，1.32；95% 置信区间，1.07-1.67）年轻女性（<55 岁）的超额死亡率较男性不那么明显。老年患者死亡率下降的性别差异较低（性别、年龄和年份之间的相互作用，P=0.004）。入院时合并症和临床严重程度特征的变化占这些死亡率趋势的 90% 以上。近年来，女性，尤其是年轻女性，心肌梗死后的住院死亡率比男性有更大的改善。年轻女性和男性之间死亡率差距的缩小很大程度上归因于风险状况的暂时变化。
Previous studies have shown that women younger than 55 years have higher hospital mortality rates after acute myocardial infarction (MI) than age-matched men. We examined whether such mortality differences have decreased in recent years. We investigated temporal trends in the hospital case-fatality rates of MI by sex and age from June 1, 1994, through December 31, 2006. The study population included 916 380 patients from the National Registry of Myocardial Infarction with a confirmed diagnosis of MI. In-hospital mortality decreased markedly between 1994 and 2006 in all patients but more so in women than men. The mortality reduction in 2006 relative to 1994 was largest in women younger than 55 years (52.9%) and lowest in men younger than 55 years (33.3%). In patients younger than 55 years, the absolute decrease in mortality was 3 times larger in women than men (2.7% vs 0.9%). As a result, the excess mortality in younger women (<55 years) compared with men was less pronounced in 2004-2006 (unadjusted odds ratio, 1.32; 95% confidence interval, 1.07-1.67) than it was in 1994-1995 (unadjusted odds ratio, 1.93; 95% confidence interval, 1.67-2.24). The sex difference in mortality decrease was lower in older patients (P=.004 for the interaction among sex, age, and year). Changes in comorbidity and clinical severity features at admission accounted for more than 90% of these mortality trends. In recent years, women, particularly younger ones, experienced larger improvements in hospital mortality after MI than men. The narrowing of the mortality gap between younger women and men is largely attributable to temporal changes in risk profiles.
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影响因子：
24
作者：
Setoguchi, Soko;Glynn, Robert J.;Winkelmayer, Wolfgang C.
通讯作者：
Winkelmayer, Wolfgang C.
影响因子：
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作者：
Simon, Tabassome;Mary-Krause, Murielle;Danchin, Nicolas
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Mosca, L;Linfante, AH;Simpson, SL
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Simpson, SL
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通讯作者：
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影响因子：
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作者：
Mosca, L;Mochari, H;Simpson, SL
通讯作者：
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