Sex differences in the non-invasive risk stratification and prognosis after myocardial infarction

J Electrocardiol. 2014 Nov-Dec;47(6):874-80. doi: 10.1016/j.jelectrocard.2014.08.010. Epub 2014 Aug 12.

Abstract

Background: Women have unfavorable prognosis after myocardial infarction (MI). This text describes sex differences in mortality and in the power of risk predictors in contemporarily-treated MI patients.

Methods: A population of 4141 MI patients (26.5% females) was followed up for 5years. Effects of sex and age on total mortality were investigated by multivariable Cox analysis. Mortality predictors were investigated by receiver-operator characteristics analysis. Stepwise multivariable Cox regression was used to create sex-specific predictive models.

Results: Thirty-day mortality was 1.5-fold higher in women. However, sex was not a significant mortality predictor in a model adjusted for age. Predictors for 5-year mortality performed differently in male and female patients. In women, a sex-specific model provided better risk stratification than a sex-neutral model.

Conclusion: The unfavorable prognosis of female MI patients can be explained by advanced age. Sex-specific predictive models might improve risk stratification in female survivors of acute MI.

Keywords: ECG; Gender; Myocardial infarction; Risk stratification.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Electrocardiography, Ambulatory / statistics & numerical data*
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / mortality*
  • Prognosis
  • Proportional Hazards Models
  • Risk Factors
  • Sex Characteristics
  • Sex Distribution
  • Survival Rate