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June 12, 2006

Improving Outcomes for Women With Myocardial Infarction

Arch Intern Med. 2006;166(11):1162-1163. doi:10.1001/archinte.166.11.1162

The descriptive epidemiological features of myocardial infarction (MI) are different in women than in men. Women who have an MI are older at the time of the MI than men, on average, by at least 5 years. Women commonly have different symptoms of coronary disease than men, and tests to detect ischemia operate differently in women than in men. Outcomes after MI in women are generally reported to be worse than those in men, with higher case fatality rates in the hospital and at 30 days and 1 year after an MI.1-4 Some,2,3 but not others,1,4 attributed poorer outcomes in women to older age alone. In addition, some studies3-8 have also suggested that women receive less intense approaches to treatment than do men once they are recognized as having an MI, and it is speculated that treatment differences between men and women contribute to poorer outcomes in women. In sum, the combination of older age at presentation, greater delays in seeking medical treatment, and lower intensity of treatments after hospitalization apparently all contribute to poorer outcomes in women. The encouraging news has been that some of these factors contributing to poor outcome are potentially reversible.