[Impact of gender on in-hospital death in hospitalized patients with acute myocardial infarction].

OBJECTIVE: To investigate whether gender is an independent predictor of in-hospital death in hospitalized patients with acute myocardial infarction (AMI).

METHODS: This retrospective study compared baseline characteristics, therapeutic approaches and the occurrence rate of angina pectoris, reinfarction, heart failure and death during hospitalization between 1501 male and 635 female hospitalized patients with AMI. Multivariate logistic regression analysis was performed to identify risk factors predicting in-hospital death.

RESULTS: In-hospital death rate was significantly higher in female than male patients with AMI (11.7% vs. 6.3%, P < 0.01). Female patients with AMI were significantly older than male patients [(67.8 +/- 9.2) years vs. (61.1 +/- 11.9) years, P < 0.01] had a higher incidence of hypertension (52.1% vs. 41.1%, P < 0.01), diabetes mellitus (35.4% vs. 17.3%, P < 0.01), cardiac function > or = Killip class III (11.7% vs. 5.1%, P < 0.01) and TC > 4.68 mmol/L (71.3% vs. 55.0%, P < 0.01). Cigarette smoking, however, was more common in males than in females (69.4% vs. 15.7%, P < 0.01). Reperfusion therapy within the first 24 hours after symptom onset, beta-blockers and statins use during hospitalization were significantly fewer in females compared with males (22.2% vs. 31.5%, P < 0.01; 64.6% vs. 71.2%, P = 0.003; 43.1% vs. 48.0%, P = 0.041, respectively). An increased mortality was demonstrated in females during the hospitalization phase of AMI (11.7% vs. 6.3%, P < 0.01). The results of logistic regression demonstrated that age, diabetes mellitus, hypertension, Killip classification of cardiac function, administration of reperfusion therapy and beta receptor blockers use were significant predictors of in-hospital death in patients with AMI, with odds ratios being 1.06 (95% CI: 1.04 - 1.08), 1.96 (95% CI: 1.32 - 2.90), 1.80 (95% CI: 1.25 - 2.58), 2.86 (95% CI: 2.35 - 3.48), 0.44 (95% CI: 0.30 - 0.66) and 0.51 (95% CI: 0.36 - 0.74), respectively.

CONCLUSIONS: The in-hospital mortality of females is significantly higher than that of males in this patient cohort. Older age, higher risk factor rates, less reperfusion therapy and beta-blockers use contributed to the higher in-hospital mortality in female patients with AMI compared to males.