Gender, age and risk of ST segment elevation myocardial infarction

Exact associations of gender and age with occurrence of ST segment elevation myocardial infarction are inadequately known.

Gender and age differences in frequency and incidence of ST segment elevation myocardial infarction (STEMI were studied using a nationwide, population-based (26 723 956 person-years) registry of hospital admissions in patients aged ≥ 30 during 2001-2008 in Finland. Data were collected from all 22 hospitals with a coronary angiolaboratory nationwide.

The study period included 27 993 STEMI admissions. Of these patients, 65·9% were men and 34·1% women, RR 2·37 (95% CI 2·05-2·74, P < 0·0001). Women were significantly older than men (74·3 ± 11·7 vs. 64·7 ± 12·4 years, P < 0·0001). Standardized incidence rate of STEMI was 113·0/100 000 person-years overall, 170·9/100 000 in men and 66·6/100 000 in women. Men had a 3·03 (95% CI 2·86-3·21; P < 0·0001)-fold age-adjusted relative risk of STEMI compared with women with highest risk difference in population under the age of 55 years (RR 5·94; 95% CI 5·36-6·58, P < 0·0001). Incidence increased with age up to 90 years old, with estimated gender-adjusted increase rate of 41% (95% CI 40-42%; P < 0·0001) per 5-year increase in age. Incidence rate had a slowly declining trend (-2·2%; 95% CI -3·4 to -1·0% per year, P < 0·001) during the study period.

Men have a tripled overall risk of STEMI compared with women with highest relative risk in younger adults. Incidence rate of ST segment elevation myocardial infarction increases by estimated 41% per 5-year increase in age.