Infarto agudo del miocardio en Chile: diferencias entre hombres y mujeres en su evolución y pronóstico / Myocardial acute infarction in Chile: diferences between male and female in its evolution and prognostic

ABSTRACT

Gender may be prognostic factor for the evolution of acute myocardial infarction and women may have higher mortality and complication rates. To study if there are differences in the evolution of acute myocardial infarction between men and women, we have recorded information on risk factors, clinical evolution, treatment and complications of 2052 patients hospitalized for acute myocardial infarction in 36 chilean hospitals. The odds ratio for female sex and mortality was calculated using a logistic regression analysis adjusted for risk factors, treatment, invasive procedures and complications. Twenty six percent of analyzed patients were female. Mortality rates among females and males were 11,8 and 20,2 percent respectively (p<0.01). Women had higher frequency of smoking, diabetes, obesity and hypertension. Blood lipid levels were similar in both sexes. Compared to men, a lesser proportion of women were treated with thrombolytic agents (25 and 35 percent respectively) intravenous heparin (54 and 61 percent respectively), beta blockers (31 and 42 percent respectively) and intravenous nitrates (53 and 61 percent respectively). Also, women were subjected to less invasive procedures. The odds ratio for mortality and sex was 1.72 (confidence interval from 1.13 to 2.62). Female sex is an independent risk factor for acute myocardial infarction mortality