Lower MI Survival in Women May Be Due to Poorer Management

Previous reports have found that mortality after myocardial infarction (MI) is greater for women than for men. Now, Scottish researchers suggest that this may reflect gender differences in management.

Our results "support the view that if women have access to the same quality of care as men then survival will be the same," senior author Dr. Christopher G. Isles, from the Dumfries and Galloway Royal Infirmary, and colleagues note.

The findings, which appear in the March issue of Heart, are based on a study of 966 men and 597 women who were admitted with first MI to a general hospital in Scotland between 1994 and 2000.

During a median follow-up period of 3.4 years, 393 men (40.7%) and 305 women (51.1%) died. Although the initial analysis showed a heightened mortality risk for women, this disappeared after adjusting for age, smoking, various comorbidities, and social deprivation. An increased risk for 30-day mortality among women also disappeared after controlling for these factors.

Further analysis showed that women were more likely than men to be treated with statins and less likely to receive beta-blockers. Little difference in thrombolysis rates was noted between the sexes.

Based on these findings, the researchers conclude that "it is tempting to speculate... that the differences in survival reported in other studies may reflect sex bias in management as well as differences in age and comorbidity."

Heart 2005;91:305-307.