Influence of gender in the therapeutic management of patients with acute myocardial infarction in Israel

Solomon Behar, Shmuel Gottlieb, Hanoch Hod, Ron Narinsky, Boaz Benari, Eldad Rechavia, Hana Pauzner, Natan Rougin, Oskar H. Kracoff, Amos Katz, Arie Roth, Ehud Goldhammer, Leonid Rudnik, Hedy E. Faibel, Chaim Lotan, Chen Shapira, Jamal Jafari, Nahum A. Freedberg, Fatchy Daka, Menahem KanettiTedi Weiss, Eddy Barasch, Mark Klutstein, David Blondheim, Nabil Mahul, Alen Gelvan, Gabriel Barbash

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

A national study was performed in early 1992 in the 25 operating coronary care units in Israel, which enabled the assessment of whether the therapeutic management of patients with acute myocardial infarction was affected by patient gender. During a 2-month period, 1,014 consecutive patients with acute myocardial infarction were hospitalized. Thrombolytic therapy was given to 47% of men (362 of 769), and 43% of women (106 of 245) (p = NS). After adjustment for age, no gender differences in the administration of thrombolytic therapy were noted (odds ratio 0.95; 95% confidence interval 0.73-1.23). Coronary angiography was more frequently performed in men (22%) than in women (16%) (p <0.05). However, no gender differences in the use of angioplasty or coronary bypass surgery performed during the index hospitalization were found (10% in men, and 8% in women). The main reasons for ineligibility for thrombolytic therapy were: late hospital arrival, absence of qualifying ST-T changes on admission electrocardiogram, and contraindications to thrombolytic therapy. Hospital death was significantly lower in patients receiving thrombolytic therapy (37 of 456; 8%) than in those excluded from thrombolysis (70 of 540; 13%) (p <0.01). This difference was significant for men, but not for women. The 1-year postdischarge mortality was 4% in patients treated compared with 12% in those ineligible for thrombolysis (p <0.01). This significant difference persisted among men and women.

Original languageEnglish
Pages (from-to)438-443
Number of pages6
JournalAmerican Journal of Cardiology
Volume73
Issue number7
DOIs
StatePublished - 1 Mar 1994
Externally publishedYes

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