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European Heart Journal 2001 22(9):762-768; doi:10.1053/euhj.2000.2501
Copyright © 2001 by the European Society of Cardiology.
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Gender differences in recurrent coronary events. The FINMONICA MI register

P.J Schreinera, M Niemeläb, H Miettinenc,d, M Mähönenb, M Ketonene, P Immonen-Räihäf, S Lehtog, T Vuorenmaah, P Palomäkig, H Mustaniemie, E Kaarsaloh, M Arstilai, J Torppab, P Puskab, J Tuomilehtob, K Pyöräläg and V Salomaab,f1

a Division of Epidemiology, University of Minnesota, Minneapolis, MN, U.S.A.
b Department of Epidemiology and Health Promotion, KTL-National Public Health Institute, Helsinki, Finland
c Department of Medicine, Kuopio University Hospital, Kuopio, Finland
d Department of Medicine, Jyväskylä Central Hospital, Jyväskylä, Finland
e Department of Medicine, North Karelia Central Hospital, Joensuu, Finland
f Raisio Regional Hospital, Raisio, Finland
g Department of Medicine, Kuopio University Hospital, Kuopio, Finland
h Department of Medicine, Loimaa District Hospital, Loimaa, Finland
i Department of Medicine, Turku University Hospital, Turku, Finland

revised September 20, 2000; accepted October 11, 2000

Abstract

Background Male gender is an established risk factor for first myocardial infarction, but some studies have suggested that among myocardial infarction survivors, women fare worse than men. Therefore, we examined the long-term prognosis of incident myocardial infarction survivors in a large, population-based MI register, addressing gender differences in mortality as well as the number of events and time intervals between recurrent events.

Methods and Results Study subjects included 4900 men and women, aged 25–64 years, with definite or probable first myocardial infarctions who were alive 28 days after the onset of symptoms. At first myocardial infarction, women were older and more likely to be hypertensive or diabetic than men, and had a greater proportion of probable vs definite events. After adjustment for age and geographic region, men had 1·74 times the risk of fatal coronary heart disease relative to women (hazard ratio=1·63 and 1·55 for cardiovascular disease and all-cause mortality, respectively) over an average of 5·9 years of follow-up. Number and time intervals between any recurrent event—fatal and non-fatal—did not differ by gender.

Conclusion These data suggest that men are far more likely to have a fatal recurrent event than women despite comparable numbers of events.

Key Words: Myocardial infarction, prognosis, women, MONICA

f1 Correspondence: Dr Veikko Salomaa, KTL-National Public Health Inst., Mannerheimintie 166, FIN-00320 Helsinki, Finland.

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