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Sex differences in short- and long-term case-fatality of myocardial infarction

  • Cardiovascular Disease
  • Published:
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Abstract

Declining trends in case fatality (CF) of MI events have been generally reported in western countries. It is, however, not clear whether the development has been equally beneficial in both sexes. Data from two large population based registers, FINAMI and the Finnish National Cardiovascular Disease Register (CVDR) were used to determine whether the CF of incident MI events has declined less in women than in men. All patients aged 35 and over were included. CF was calculated for different time periods after the onset of the MI event, the main emphasis was in pre-hospital, 28-day, and 1-year CF. Figures were compared between two study periods: 1994–1996 and 2000–2002. A total of 6,342 incident MI events were recorded in FINAMI and 117,632 events in CVDR during the study periods. Comparison between the two study periods showed that the CF was generally declining. However, a slower decline in short-term CF was seen among young (aged < 55 years) women (P for sex by study period interaction in pre-hospital CF = 0.028 in FINAMI and 0.003 in CVDR, and for 28-day CF P = 0.016 in FINAMI and <0.0001 in CVDR). In conclusion, the short and long-term prognosis of MI events has improved in both sexes. Pre-hospital CF has declined less among younger women than among men and among older women. This slower decline in early CF was responsible for the slower improvement in 28-day and 1-year prognosis in young women.

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Abbreviations

CF:

Case fatality

CHD:

Coronary heart disease

MI:

Myocardial infarction

PCI:

Percutaneous coronary intervention

STEMI:

ST-elevation myocardial infarction

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Acknowledgments

Supported by grants from the Finnish Foundation for Cardiovascular Research to HRL and VS. We have no relationships with industry relevant to the present study.

Conflict of Interest

None to declare.

Author information

Authors and Affiliations

  1. Department of Medicine, University of Kuopio and Kuopio University Hospital, 70210, Kuopio, Finland

    Hanna-Riikka Lehto & Seppo Lehto

  2. THL—National Institute for Health and Welfare, Helsinki, Finland

    Aki Samuli Havulinna & Veikko Salomaa

  3. North Karelia Central Hospital, Joensuu, Finland

    Matti Ketonen

  4. Turku Town Hospital, Turku, Finland

    Aapo Lehtonen

  5. Department of Internal Medicine and Biocenter Oulu, Oulu University Hospital and Institute of Clinical Medicine, University of Oulu, Oulu, Finland

    Yrjö Antero Kesäniemi

  6. Turku University Hospital, Turku, Finland

    Kari Juhani Airaksinen

Authors
  1. Hanna-Riikka Lehto
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  2. Seppo Lehto
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  3. Aki Samuli Havulinna
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  4. Matti Ketonen
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  5. Aapo Lehtonen
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  6. Yrjö Antero Kesäniemi
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  7. Kari Juhani Airaksinen
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  8. Veikko Salomaa
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Corresponding author

Correspondence to Hanna-Riikka Lehto.

Additional information

This study is conducted by FINAMI Study Group.

All investigators of the FINAMI Study Group are listed in the Appendix.

Appendix: Investigators of the FINAMI Study Group

Appendix: Investigators of the FINAMI Study Group

Kuopio University Hospital: Heli Koukkunen, Seppo Lehto, Heikki Miettinen, Kalevi Pyörälä

North Karelia Central Hospital: Matti Ketonen, Juha Mustonen

Oulu University Hospital and Biocenter Oulu:Tapani Jerkkola, Y. Antero Kesäniemi

Oulu City Hospital: Päivi Kärjä-Koskenkari

Turku University Hospital: Pirjo Immonen-Räihä, Juhani Airaksinen, Tapio Vuorenmaa

Turku Town Hospital: Aapo Lehtonen

THL-National Institute for Health and Welfare: Veikko Salomaa, Kari Kuulasmaa, Aki S. Havulinna, Jorma Torppa, Anne Juolevi, Jaakko Tuomilehto

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Lehto, HR., Lehto, S., Havulinna, A.S. et al. Sex differences in short- and long-term case-fatality of myocardial infarction. Eur J Epidemiol 26, 851–861 (2011). https://doi.org/10.1007/s10654-011-9601-6

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  • DOI: https://doi.org/10.1007/s10654-011-9601-6

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