Physicians' Academy for Cardiovascular Education

Women with AMI have higher CV death compared with men and may benefit from better adherence to guidelines

Sex Differences in Treatments, Relative Survival, and Excess Mortality Following Acute Myocardial Infarction: National Cohort Study Using the SWEDEHEART Registry

Literature - Alabas OA, Gale CP, Hall M, et al. - J Am Heart Assoc 2017;6:e007123

Background

Although several studies showed that following an acute myocardial infarction (AMI), gender is no longer an independent predictor of death after adjustment for age and comorbidities, there are still differences in the estimates of the impact of gender on post-MI survival. This is partly because women without AMI have a better underlying prognosis than men without AMI, and due to the use of all-cause mortality as the clinical outcome to report survival [1-4].

In this study, the impact of gender on relative survival and excess mortality following AMI was evaluated, in a population-based cohort within a relative survival framework. Moreover, factors associated with differences in survival were identified. 180,368 patients included in the SWEDEHEART registry [5], aged >18 years and hospitalized for AMI between 2003 and 2013, were eligible for the analysis. The primary outcome was excess mortality at 6 months, 1 year, and 5 years following hospitalization for AMI.

Main results

Conclusion

Women with AMI in Sweden had a higher excess mortality compared with men, which was reduced after adjustment for the use of guideline-indicated treatments. This finding suggests that improved adherence to guideline recommendations for the treatment of AMI may reduce premature CV death among women.

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