ACUTE MYOCARDIAL INFARCTION

EVIDENCE FOR A SEX-AGE INTERACTION

Abstract

Women with acute myocardial infarction have higher in-hospital mortality
than men mainly due to greater age on presentation. Objective: To evaluate the age specific sex difference in inhospital
mortality of acute myocardial infarction. Design: Descriptive study. Place and duration: Coronary Care Unit
and cardiology ward of Nishtar Hospital Multan from 15 of th September 2002 till 30th of April 2003. Material & Methods:
Four hundred and fifty patients of acute myocardial infarction who fulfilled our inclusion criteria were studied while they
were admitted to the hospital. Patients were divided into four groups according to age and sex i.e. Group I (male <45
years), Group II (male $45 years), Group III (female <45 years) and Group IV (female $45 years). In-hospital mortality
was compared between different age groups by Chi-square test. Results: The total in-hospital mortality was
76(16.9%).In Group III none of the patients expired. In Group I in-hospital mortality was 6(7.1%) patients followed by
Group II 50(18.3%) patients and Group IV 20(23.3%) patients p<0.019. In-hospital mortality was greater in Group IV
than in any other group. Group IV patients were more frequently diabetic and hypertensive than patients in any other
group. Group IV patients presented late to the hospital. There was no significant difference in site of myocardial
infarction in different groups. Higher Killip class was observed in Group II and IV p<0.05. Streptokinase injection was
given less frequently in Group IV than in any other group p <0.012. Only 34(39.5%) patients in Group IV had no
complication during hospital stay while more patients in other groups had uneventful hospital stay p<0.001.
Conclusion: Female sex is associated with higher in-hospital mortality in older age group as compared to the male
patients of same age group.