Title

Sex differences in survival after acute myocardial infarction in patients with diabetes mellitus (Worcester Heart Attack Study)

UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine

Date

11-5-2003

Document Type

Article

Medical Subject Headings

Aged; Comorbidity; Diabetes Mellitus; Female; Hospital Mortality; Humans; Hypertension; Male; Massachusetts; Middle Aged; Myocardial Infarction; Regression Analysis; Sex Distribution; Survival Rate

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

BACKGROUND: Women with diabetes mellitus are at particularly high risk for coronary heart disease-related morbidity and mortality compared with men with diabetes mellitus. However, recent data comparing hospital and long-term outcomes in women with diabetes mellitus and men hospitalized with acute myocardial infarction (AMI) are scarce. The objectives of our multi-hospital observational study were to examine sex differences and temporal trends (1975-99) in hospital and long-term case-fatality rates (CFRs) in patients with diabetes mellitus and AMI from a population-based perspective.

METHODS: A community-wide study of residents of the Worcester, Mass, metropolitan area who were hospitalized with confirmed AMI was conducted. Data were collected in 12 1-year periods between 1975 and 1999. The study sample consisted of 1354 men and 1280 women with diabetes mellitus.

RESULTS: Overall hospital CFRs were significantly greater for women with diabetes mellitus (21.3%) than for men with diabetes mellitus (14.9%). Between 1975 and 1999, hospital CFRs declined from 39.2% to 17.5% for women and from 18.9% to 9.5% in men. In examining long-term survival patterns for as long as 10 years after hospital discharge, there were no significant sex differences in long-term survival rates after adjustment for a limited number of known potentially confounding factors.

CONCLUSIONS: Hospital death rates after AMI in men and women with diabetes mellitus have declined in the last 2 decades. The gap in hospital CFRs between men and women with diabetes mellitus has decreased considerably with time, although women have a higher risk of dying after AMI than men. Patients with diabetes mellitus continue to represent a high-risk group who will benefit from enhanced surveillance efforts and increased use of effective cardiac treatments.

Rights and Permissions

Citation: Am Heart J. 2003 Nov;146(5):824-31. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Comments

Amber Crowley participated in this study initially as a UMMS medical student for the Senior Scholars research program.


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