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Article
Sex differences in survival after acute myocardial infarction in patients with diabetes mellitus (Worcester Heart Attack Study)
Senior Scholars Program
  • Amber Crowley, Yale University School of Medicine
  • Vandana Menon, Tufts University School of Medicine
  • Darleen M. Lessard, University of Massachusetts Medical School
  • Jorge L. Yarzebski, University of Massachusetts Medical School
  • Elizabeth A. Jackson, University of Massachusetts Medical School
  • Joel M. Gore, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
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
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.
PubMed ID
14597931
Citation Information
Amber Crowley, Vandana Menon, Darleen M. Lessard, Jorge L. Yarzebski, et al.. "Sex differences in survival after acute myocardial infarction in patients with diabetes mellitus (Worcester Heart Attack Study)" Vol. 146 Iss. 5 (2003) ISSN: 1097-6744 (Linking)
Available at: http://works.bepress.com/jorge_yarzebski/10/