摘要
许多研究都已经表明:与男性急性心肌梗死(AMI)患者相比,女性患者AMI后的长期和短期死亡率均增高。对该死亡率差异的原因仍存在争议。分析了1246例男性AMI患者和537例女性AMI患者的基线特征、院内治疗和短期后果,以期识别可预测性别之间死亡率差异的临床指标。
Many studies have demonstrated that, compared with men, women have increased long-and short-term mortality after acute myocardial infarction (AMI). The reasons for this mortality difference remain in dispute. We analyzed baseline characteristics, in-hospital management, and short-term outcomes of 1,246 men and 537 women with AMI to identify clinical variables that can predict the in-hospital mortality difference between genders. A higher in-hospital mortality was found in women with AMI than in men (11.9%vs 6.9%, p < 0.001). Women were generally older, had a higher incidence of hypertension, diabetes mellitus, and hyperlipidemia, and had a higher Killip class of cardiac function compared with men. Reperfusion therapy and β-receptor blockers were underused in women. Using a multivariate logistic regression model, we identified age, history of hypertension and diabetes mellitus, Killip class of cardiac function, and administration of reperfusion therapy and β-receptor blockers as significant predictors of in-hospital mortality in patients with AMI, with odds ratios of 1.05 (95%confidence interval [CI] approximately 1.03 to 1.07), 1.65(95%CI 1.12 to 2.41), 1.92(95%CI 1.27 to 2.90), 3.62(95%CI 2.88 to 4.56), 0.39(95%CI 0.24 to 0.66), and 0.63(95%CI 0.43 to 0.93), respectively. In conclusion, women with AMI had a higher in-hospital mortality rate than did men, probably due to older age, higher incidence of hypertension, diabetes mellitus, and hyperlipidemia, a higher Killip class of cardiac function, and less utilization of reperfusion therapy and β-receptor blockers.
