A paper published online by the journal Circulation concluded that, while men and women have a similar in-hospital death rate following acute myocardial infarction, women with STEMI had an adjusted mortality rate almost twice as high as men (10.2% versus 5.5%). These differences were associated with a lower likelihood of reperfusion therapy in women. The paper was widely reported in the press, with suggestions of disparity in care and outcome after AMI.
This study is one of many undertaken in the past 20 years on gender differences in the management of acute coronary events. Many, like this latest study, have found that women are treated less intensively in the acute phase. However, after adjustment for age, co-morbidity and severity of disease, some of these disparities have been found to disappear. Similarly, many studies have found gender differences in short-term survival rates after AMI, but such differences have not always persisted in the long term.
In Europe results from a Swedish cohort study of 53,781 subjects (of whom 37 per cent were women) also showed that overall women were less intensively treated than men, but, in cases of non-STEMI, had a better long-term prognosis than men.
Commenting for the ESC on the STEMI results in the Circulation paper, Professor Eva Swahn (University Hospital, Link?