American Journal of Epidemiology Vol. 152, No. 10 : 965-973
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Long-term Outcome of Myocardial Infarction in Women and Men: A Population Perspective
1 Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT.
2 Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA.
3 Department of Internal Medicine Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT.
4 Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT.
Because of women's survival advantage, the impact of myocardial infarction (MI) on long-term mortality in women compared with men may be underestimated. The authors examined this issue in a community sample of 2,462 persons aged 
65 years living in New Haven, Connecticut, who were free of MI at baseline and were followed for 10 years (1982–1992). By using proportional hazards models with MI hospitalizations and the sex-MI interaction as time-dependent covariables, survival for the MI cases from the date of MI was compared with survival of persons who, at the same follow-up time, were still alive and free of MI. Women survived longer than men mainly in the absence of MI. The multivariable-adjusted hazard ratios of death were 0.53 in the absence and 0.87 in the presence of MI, and MI was associated with a greater risk of death in women (adjusted hazard ratio = 5.9) than in men (adjusted hazard ratio = 3.6) (p = 0.01 for the sex-MI interaction). When out-of-hospital fatal infarctions were considered, the impact of MI on survival in women compared with men increased. In conclusion, in this elderly cohort, when viewed from a population perspective, MI had a greater impact on mortality in women and significantly narrowed women's typical survival advantage over men. Am J Epidemiol 2000;152:965–73.
coronary disease; mortality; myocardial infarction; population surveillance; sex factors; women
Abbreviations: CHD, coronary heart disease; CI, confidence interval; EPESE, Established Populations for Epidemiologic Studies of the Elderly; HR, hazard ratio; MI, myocardial infarction.
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