0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Comparison of Clinical Outcomes for Women and Men after Acute Myocardial Infarction

Richard C. Becker, MD; Michael Terrin, MD; Richard Ross, MS; Genell L. Knatterud, PhD; Patrice Desvigne-Nickens, MD; Joel M. Gore, MD; Eugene Braunwald, MD, Thrombolysis in Myocardial Infarction Investigators*
[+] Article and Author Information

From the Thrombosis Research Center, University of Massachusetts Medical School, Worcester, Massachusetts; the TIMI Coordinating Center, Maryland Medical Research Institute, Baltimore, and the National Heart, Lung, and Blood Institute, Bethesda, Maryland; Brigham and Women's Hospital, Boston, Massachusetts. Requests for Reprints: Richard C. Becker, MD, Thrombosis Research Center, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. Grant Support: By research contracts from the National Heart, Lung, and Blood Institute and by grants HL35058 and HL38460 from the same organization.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1994;120(8):638-645. doi:10.7326/0003-4819-120-8-199404150-00003
Text Size: A A A

Objectives: To assess differences in morbidity and mortality between men and women with acute myocardial infarction treated with thrombolytic therapy and the relation of differences to baseline patient characteristics and clinical features.

Design: Secondary analysis of observational findings among women and men enrolled in a clinical trial.

Setting: Hospitals participating in the Thrombolysis in Myocardial Infarction Phase II trial.

Measurements: Recurrent infarctions and deaths were assessed.

Main Results: The 6-week mortality rate was greater for women than for men (9% compared with 4%; adjusted relative risk, 1.54; P = 0.01). Death or reinfarction occurred in 15.9% of women and 9.5% of men (adjusted relative risk, 1.33; P = 0.02). Among patients enrolled for treatment with 100 mg of recombinant tissue plasminogen activator and assigned to a conservative strategy of watchful waiting with appropriate backup, the 6-week incidence of death was 7.5% for women and 3.8% for men (P = 0.01). The 6-week incidences of death or reinfarction were 14.2% and 8.9% (P = 0.01) among women and men, respectively.

Conclusions: Among patients in the Thrombolysis in Myocardial Infarction Phase II Trial, who all were diagnosed with myocardial infarction and were eligible to receive thrombolytic therapy, women had higher rates of mortality and morbidity than did men. Older age at the time of myocardial infarction and a history of diabetes accounted for much but probably not all of this difference.

*A complete list of TIMI Investigators has been published previously (see Ref. 17).

Figures

Grahic Jump Location
Figure 1.
One-year Kaplan-Meier mortality curves for women and men.

The solid line represents men; the broken line represents women.

Grahic Jump Location
Grahic Jump Location
Figure 2.
One-year Kaplan-Meier event rates for reinfarction in women and men.

The solid line represents men; the broken line represents women.

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)