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Gender differences in mortality after acute myocardial infarction Wrightson, Jacqueline Dorene

Abstract

Women die after AMI at a rate approximately double that of men (Blister et al., 2000), as evidenced by an abundant number of epidemiological and clinical studies. Contentious debate about this alarming problem has been fueled by inadequate conceptualization of the problem, and misread evidence resulting from selection bias. The purpose of this study was to examine gender differences in the associations between sociodemographics and comorbidities (CHF, hypertension, diabetes) and short-term mortality after AMI. Surprisingly, there is no published study to date that has examined the effects of these factors on mortality after AMI in the Canadian context. The study was of exploratory, descriptive design and secondary analysis was used. The AMI cohort (n = 1, 365) was the total population of patients (342 women, 827 men) in 1994 diagnosed with AMITCD 9 Code 410 and admitted to a BC hospital. A logistic regression model was used to assess independently the effects of age and gender and to control the effects of possible confounders (CHF, hypertension, diabetes, SES) on the outcome variable (mortality). Significantly more women (19.9%) died after AMI compared to men (10.5%; odds ratio 1.81, 95% CI 1.24 - 2.64) within the initial hospitalization. CHF was a significant predictor of mortality (odds ratio 1.76, 95% CI 1.05 - 2.93), hypertension, diabetes, and SES Quintile were not significant predictors. The results of this study have implications for critically needed research on gender differences in mortality after AMI, judicious screening/monitoring of women, follow-up, and population health.

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