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Editor's Correspondence
December 7/21, 1998

Differences in Treatment and Outcome for Women With Acute Myocardial Infarction

Arch Intern Med. 1998;158(22):2513. doi:

The recent article by Chandra et al1 based on an analysis of National Registry of Myocardial Infarction data concluded that sex differences were evident in the treatment and outcome of patients with myocardial infarction. Several other recent articles have addressed the issue of differences in treatment and outcome based on the sex of patients with myocardial infarction.24 Based on an analysis of the Third International Study of Infarct Survival data, Malacrinda et al2 suggest that there is only a small association between female sex and early mortality and morbidity after suspected myocardial infarction. In a study of patients who receive Medicare, Krumholz et al3 found that, based on the clinical judgment of the treating physician, many eligible and ideal patients are not receiving appropriate therapy and suggest that this finding may not be consistent with published literature, thus representing a missed opportunity to treat and possibly alter outcomes. Delay in presentation and increased age were the most common factors cited for nontreatment. Gurwitz et al4 noted that factors associated with delay in presentation were linked to age and female sex.

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