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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Cardiovascular Disorders 1/2017

Gender differences in all-cause, cardiovascular and cancer mortality during long-term follow-up after acute myocardial infarction; a prospective cohort study

Zeitschrift:
BMC Cardiovascular Disorders > Ausgabe 1/2017
Autoren:
Kristin Marie Kvakkestad, Morten Wang Fagerland, Jan Eritsland, Sigrun Halvorsen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12872-017-0508-3) contains supplementary material, which is available to authorized users.

Abstract

Background

Gender differences in short-term mortality in acute myocardial infarction (AMI) have been studied extensively, whereas gender differences in long-term mortality and cause of death largely remain unknown. The aim of this study was to assess the long-term risk of all-cause, cardiovascular and cancer death after AMI in women compared to men.

Methods

Consecutive AMI patients were enrolled in a prospective registry between 2005 and 2011. Date and cause of death were obtained by linkage with the Norwegian Cause of Death Registry, with censoring date 31 December 2012. AMI patients with ST-segment elevation (STEMI, n = 5159) and without (NSTEMI, n = 4899) were analysed separately.

Results

The 5-years all-cause mortality rates in STEMI were 29% in women vs. 17% in men, and 42% vs. 29% in NSTEMI, respectively. After adjustment for age and other confounders, women with STEMI had similar (HR 1.13 [95% CI: 0.98–1.32]) and women with NSTEMI lower (HR 0.82 [95% CI: 0.73–0.92]) risk of long-term all-cause mortality compared to men. Competing-risks analysis showed no significant gender differences in age-adjusted risk of cardiovascular death nor of cancer death. In both genders, the annual risk of cardiovascular death was low after 1 year, but exceeded annual risk of cancer death throughout follow-up.

Conclusion

During long-term follow-up, women with STEMI had similar and women with NSTEMI lower adjusted risk of all-cause mortality compared to men. Age-adjusted risk of death due to cardiovascular disease was similar in both genders and higher than risk of death due to cancer throughout the follow-up period.
Zusatzmaterial
Additional file 1: Appendix Table A1. Medications in-hospital for women and men with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). (DOCX 20 kb)
12872_2017_508_MOESM1_ESM.docx
Additional file 2: Appendix Table A2. Complications in-hospital for women and men with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). (DOCX 21 kb)
12872_2017_508_MOESM2_ESM.docx
Literatur
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