[The female sex and mortality after acute myocardial infarct]

To study the possible influence of gender on in-hospital mortality in patients suffering acute myocardial infarction.

We analyzed 1,951 consecutive patients admitted to our Coronary Unit between January 1986 and December 1991 with this diagnosis and with a delay of no more than 24 hours prior to admission.

In-hospital mortality was 12.8% in the 1,603 males and 25.6% in the 348 females (p < 0.001). Age, previous history of: not smoking, diabetes, heart failure, stable angina, myocardial infarction, stroke, right branch block, atrial fibrillation, and treatment with digoxin were variables significantly associated with greater mortality (p < 0.05) as well as the localization of the infarction, the Forrester grade and/or presence of atrioventricular block on admission and not treatment with intravenous fibrinolytics and beta-blockers. Multivariate analysis of variables associated with mortality (selection criterion for variable entry p < 0.20) shows that age, gender, previous angina, situation and extension of the infarction determined by ECG and Forrester on admission are independent predictors of in-hospital mortality.

Gender is an independent predictor of in-hospital mortality in acute myocardial infarction (female/male odds ratio = 1.63).