Gender differences in the management and survival of patients with acute myocardial infarction
Ozgür Karciogcaron;lu1, Belgin Unal Aslan, Ozgür Aslan
1Dokuz Eylül University Medical School, Department of Emergency Medicine, 35340 Inciralti, Izmir, Turkey
Insights
Acute myocardial infarction (AMI) affects men more, but women face worse short-term survival. Despite lower treatment rates, women have higher in-hospital AMI mortality, necessitating equitable care.
Area of Science:
- Cardiology
- Public Health
- Sex Differences in Medicine
Background:
- Coronary heart disease (CHD), particularly acute myocardial infarction (AMI), remains a leading global cause of death.
- While CHD mortality has decreased in developed nations, sex-based disparities in survival trends persist.
- Differences in AMI presentation and outcomes between men and women impact patient care and disease mortality.
Purpose of the Study:
- To review factors influencing post-AMI survival.
- To explore reasons for sex-based inequalities in AMI survival benefits.
- To highlight disparities in in-hospital outcomes for women post-AMI.
Main Methods:
- Literature review of studies examining sex differences in AMI.
- Analysis of factors affecting post-AMI survival and mortality.
- Comparison of treatment utilization and outcomes between men and women.
Main Results:
- Women experiencing AMI exhibit worse short-term outcomes and higher in-hospital mortality compared to men.
- Despite lower rates of thrombolytics and catheterization, women have elevated case fatality and morbidity post-infarction.
- Long-term mortality risk for women after AMI is comparable to or lower than that for men.
Conclusions:
- Significant sex-based disparities exist in acute myocardial infarction outcomes.
- Women face higher in-hospital mortality and morbidity post-AMI, even with reduced intervention rates.
- Optimal AMI treatment should be universally applied, irrespective of patient sex or age.
Abstract:
Coronary heart disease (CHD) and specifically acute myocardial infarction (AMI) are the most common causes of death among both men and women throughout the world. Although CHD mortality rates have been halved in many developed countries in recent decades, some studies have pointed out significant differences regarding time-related tendencies of mortality between the sexes. This paper briefly reviews factors related to post-AMI survival and possible reasons for inequalities in survival benefit between men and women after AMI. Presentation of AMI also exhibits differences with regard to sex, and this has some effect on patient care and on mortality from the disease. CHD morbidity and mortality rates vary with socioeconomic deprivation and social patterning in most industrialized countries. Several studies have indicated that women sustaining AMI have a higher mortality than men. Although AMI affects men in greater numbers, the short-term outcomes for women are worse. Studies suggest that, over the longer term, the mortality risk for women is lower than, or similar to, that for men. It is still a major problem that in-hospital case fatality and morbidity rates in the post-infarction period are higher for women, despite lower rates of administration of thrombolytics and catheterization. Patients admitted to the hospital with an AMI should be offered optimal treatment, irrespective of age or sex.
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