Epidemiologic research of mortality rates in women surviving acute myocardial infarction
█ Original article
Skoda Réka1, Bárczi György1, Vágó Hajnalka1, Czimbalmos Csilla1, Doan Nang K.1, Édes István1, Ruzsa Zoltán1, Dinya Elek2, Merkely Béla2, Becker Dávid1
1Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
2Semmelweis Egyetem, Digitális Egészségtudományi Intézet, Budapest
Background: According to some international and national studies, mortality rates in females surviving acute myocardial infarction (AMI) are higher than those in males. Differences in age, patomechanism, especially at younger age, as well as the less invasive aspect of the treatment are suggested as possible reasons.
The aim of our extensive epidemiologic study was to examine the mortality rates of men and women treated in the last 10 years in an interventional cardiology centre handling high amount of patients.
Methods: We performed a retrospective analysis on the data of 12120 consecutive patients surviving acute myocardial infarction between 2005 and 2014 at the Heart and Vascular Center of Semmelweis University.
Results: There was a significant difference (p<0.001) between the mean age of women (70±12.5 years) and men (64±12.8 years). The incidence of heart failure (p=0.046), CPR (p=0.017) and ventricular fibrillation (p=0.008) was significantly lower among women just as the peak troponin level (p=0.04). Considering the mean time frame, women got proper care (p=0.02) sooner. Among women below the age of 45 heart failure was more common (p=0.005) and the NSTEMI rate was higher (61%). Comparing the one month (7%/10%; p=0.68) and one-year mortality rates (16.5%/21%; p=0.13) in case of STEMI performed after 12 hours, women had worst prognosis than men.
Conclusion: Based on our examination of more than 10000 patients, our results prove that with more invasive treatment, the higher mortality of women can be avoided. The tendency of higher – but not significant – mortality rates we noticed, at younger age (<45 years) and by STEMIs performed after 12 hours, shows the higher risk of this population.