ArticlePloS one2017
Sex differences in long-term mortality among acute myocardial infarction patients: Results from the ISAR-RISK and ART studies.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 26 citations in OpenAlex.
- Middle-Aged Women and Post-Myocardial Infarction Mortality: A Vulnerable Group? Real-World Evidence from a Brazilian Public Health System Cohort.Arquivos brasileiros de cardiologia · 2025Article
- Sex and Gender-Based Differences in Outcomes of Cardiac Rehabilitation Following Acute Myocardial Infarction.Current atherosclerosis reports · 2025Review
- Susceptibility of Women to Cardiovascular Disease and the Prevention Potential of Mind-Body Intervention by Changes in Neural Circuits and Cardiovascular Physiology.Biomolecules · 2021Review
- Spatial distribution of physiologic 12-lead QRS complex.Scientific reports · 2021Article
- Sex-Based Considerations in the Evaluation of Chest Pain and Management of Obstructive Coronary Artery Disease.Current atherosclerosis reports · 2020Review
- Differential impact of a cardiac rehabilitation program in functional parameters according to patient gender.American journal of cardiovascular disease · 2020Article
- Taking cardiology clinical trials to the next level: A call to action.Clinical cardiology · 2018Review
- Age- and sex-dependent changes in sympathetic activity of the left ventricular apex assessed by 18F-DOPA PET imaging.PloS one · 2018Article
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundMortality rates in females who survived acute myocardial infarction (AMI) exceed those in males. Differences between sexes in age, cardiovascular risk factors and revascularization therapy have been proposed as possible reasons.
objectiveTo select sets of female and male patients comparable in respect of relevant risk factors in order to compare the sex-specific risk in a systematic manner.
methodsData of the ISAR-RISK and ART studies were investigated. Patients were enrolled between 1996 and 2005 and suffered from AMI within 4 weeks prior to enrolment. Patients of each sex were selected with 1:1 equivalent age, previous AMI history, sinus-rhythm presence, hypertension, diabetes mellitus, smoking status, left ventricular ejection fraction (LVEF), and revascularization therapy. Survival times were compared between sex groups in the whole study cohort and in the matched cohort.
resultsOf 3840 consecutive AMI survivors, 994 (25.9%) were females and 2846 (74.1%) were males. Females were older and suffered more frequently from hypertension and diabetes mellitus. In the whole cohort, females showed an increased mortality with a hazard ratio (HR) of 1.54 compared to males (p<0.0001). The matched cohort comprised 802 patients of each sex and revealed a trend towards poorer survival in females (HR for female sex 1.14; p = 0.359). However, significant mortality differences with a higher risk in matched females was observed during the first year after AMI (HR = 1.61; p = 0.045) but not during the subsequent years.
conclusionMatched sub-groups of post-AMI patients showed a comparable long-term mortality. However, a female excess mortality remained during first year after AMI and cannot be explained by differences in age, cardiovascular risk factors, and modes of acute treatment. Other causal factors, including clinical as well as psychological and social aspects, need to be considered. Female post-AMI patients should be followed more actively particularly during the first year after AMI.
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