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European Heart Journal Advance Access published online on January 9, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi719
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received May 9, 2005
Revised November 3, 2005
Accepted December 16, 2005

Clinical research

Impact of age and gender on in-hospital and late mortality after acute myocardial infarction: increased early risk in younger women

Results from the French nation-wide USIC registries

Tabassome Simon 1 *, Murielle Mary-Krause 2, Jean-Pierre Cambou 3, Guy Hanania 4, Pascal Guéret 5, Jean-Marc Lablanche 6, Didier Blanchard 7, Nathalie Genès 8, Nicolas Danchin 7, and on behalf of the USIC Investigators

1 Department of Pharmacology, Saint-Antoine, Pierre et Marie Curie University, 27 Rue Chaligny, 75012 AP-HP, Paris, France
2 INSERM U720, Pierre et Marie Curie University, Paris, France
3 U558 INSERM, Toulouse, France
4 Cardiology CH Aulnay, Aulnay
5 Cardiology CHU Henri Mondor Créteil
6 Cardiology, CHU Lille, France
7 Department of Cardiology, Hôpital Européen Georges Pompidou, Paris, France
8 Aventis, Paris, France

* To whom correspondence should be addressed.
Tabassome Simon, E-mail: tabassome.simon{at}chusa.jussieu.fr


  Abstract

Aims To determine whether sex differences of in-hospital and after-discharge mortality differ according to the age.

Methods and results Data of 4347 consecutive patients hospitalized within 48 h of the onset of acute myocardial infarction (AMI) were analysed. Patients were classified according to median age (68 years): Group 1 (G1) (308 women, 30-67 years), G2 (1878 men, 30-67 years), G3 (860 women, 68-89 years), and G4 (1301 men, 68-89 years). In both age groups, women were older, had more frequent co-morbidities, lower rate of reperfusion therapy, and received less anti-platelet agents, {beta}-blockers, and statins than men. The overall 1-year mortality was higher in women (25% vs. 16% in men, P < 0.0001). After adjustment, in-hospital mortality was higher only for the women in the younger age group. (G1 vs. G2: OR = 2.2, 95%CI = 1.3-3.8; G3 vs. G4: OR = 1.1, 95%CI = the risk of death, after hospital discharge, was no longer related to gender in any age group.

Conclusion The higher 1-year mortality following AMI in women is explained by the higher risk of death in young women during the first days of hospitalization. Further investigations are crucial to determine the cause in order to improve the chance of survival in younger women.

Keywords: Myocardial infarction; Sex factors; Mortality; Registries; Prognosis.
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