Gender differences in acute myocardial infarction: the University of Wisconsin experience.

OBJECTIVE: To investigate gender differences in baseline characteristics, presentation, and treatment of patients with acute myocardial infarction (MI) admitted to the University of Wisconsin Hospital Coronary Care Unit (CCU) over a 1-year period. METHODS: A retrospective review was performed on the charts of all patients (n = 293) admitted to the CCU in 1996 with a discharge diagnosis of acute MI. In 83 women and 187 men with analyzable data (n = 270), 42 factors related to baseline characteristics, presentation, treatment, and outcomes were identified and analyzed for gender differences. RESULTS: On average, women were 5 years older than men (p < .01). By univariate comparison, women were less likely than men to be smokers (p < .001); more likely to have underlying hypertension (p < .01), diabetes mellitus (p < 0.05), non-Q-wave infarctions (p < .01), and congestive heart failure (CHF, p < .05); and more likely to have received diuretics (p < .001) and ACE inhibitors (p < .01). While women were less likely than men to undergo coronary angiography (p < .05) and more likely to have echocardiograms (p < 0.05), rates of coronary artery bypass graft surgery, angioplasty, and the use of thrombolytics were similar for men and women. Clinical outcomes were similar in both groups. CHF, hypertension, and use of ACE inhibitors remained the only significant gender differences when data were adjusted for age. CONCLUSION: Comparing men and women with acute MI at UW Hospital revealed some differences in clinical characteristics and management. Except for CHF, hypertension, and use of ACE inhibitors (all of which may be related), these differences disappeared when the data were adjusted for age. This is particularly notable for the disappearance of the difference in the use of coronary angiography between men and women. The comparable use of beta-blockers, aspirin, and nitrates, and the similar clinical outcomes in men and women, suggest less gender difference in MI management at UW Hospital than reported in other studies.