Dataset Information

Sex differences in the effectiveness of statins after myocardial infarction.

ABSTRACT:

Background

We sought to investigate the sex differences in the effectiveness of statins in patients with acute myocardial infarction (AMI).

Methods

Linking hospital discharge and drug claims databases from Quebec, Canada (1998-2004), we identified statin users (n = 14 710) and non-users (n = 23 833) discharged from hospital after an AMI-related hospital stay and followed up for as long as 7 years.

Results

All-cause death rates were 4.1 and 14.6 per 100 person-years among users and non-users, respectively, whereas cardiac death rates were 2.2 and 7.4 per 100 person-years. For death from any cause, the adjusted hazard ratios associated with statin use in women were 0.61 (95% confidence interval [CI], 0.54-0.69) within 1 year of follow-up, 0.55 (0.48-0.63) at 1-3 years and 0.38 (0.31-0.49) at > 3 years; in men, the corresponding estimates were 0.54 (0.48-0.60), 0.48 (0.42-0.55) and 0.34 (0.30-0.39). For cardiac-related death, the adjusted hazard ratios associated with statin use in women were 0.70 (0.60-0.81) within 1 year, 0.56 (0.46-0.68) at 1-3 years and 0.44 (0.31-0.62) at > 3 years of follow-up, whereas in men, the estimates were 0.59 (0.51-0.69), 0.47 (0.39-0.58) and 0.37 (0.30-0.45), respectively.

Interpretation

Statin therapy after an AMI was associated with reduced rates of all-cause and cardiac mortality. The effect increased with time in both sexes, but the degree of risk reduction was less for women than for men.

SUBMITTER: Karp I

PROVIDER: S-EPMC1780088 | biostudies-literature | 2007 Jan

REPOSITORIES: biostudies-literature

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Publications

Sex differences in the effectiveness of statins after myocardial infarction.

Karp Igor I Chen Shun-Fu SF Pilote Louise L

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 20070101 3

<h4>Background</h4>We sought to investigate the sex differences in the effectiveness of statins in patients with acute myocardial infarction (AMI).<h4>Methods</h4>Linking hospital discharge and drug claims databases from Quebec, Canada (1998-2004), we identified statin users (n = 14 710) and non-users (n = 23 833) discharged from hospital after an AMI-related hospital stay and followed up for as long as 7 years.<h4>Results</h4>All-cause death rates were 4.1 and 14.6 per 100 person-years among us ...[more]

PMID: 17261830

Similar Datasets

Project description:BackgroundThe diagnosis of acute myocardial infarction (AMI) is missed more frequently in young women than men, which may be related to the cognitive psychology of the diagnostic process. Physicians start the diagnostic process by intuitively recognizing familiar symptom phenotypes, but little is known about how symptoms combine in individuals as unique symptom phenotypes. We examined how symptoms of AMI combine as unique symptom phenotypes in individual patients to compare the distribution of symptom phenotypes in women versus men.Methods and resultsThe VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) was a multicenter, observational cohort study of 3501 young adults hospitalized with AMI. Data were collected on presenting symptoms with standardized interviews and from medical record abstraction. The number and distribution of unique symptom phenotypes were compared between women and men. Because of the 2:1 female-to-male enrollment ratio, women and men were compared with permutation testing and repeated subsampling. There were 426 interview-symptom phenotypes in women and 280 in men. The observed difference between women and men of 146 phenotypes was significant, even allowing for the greater enrollment of women (permutation P=0.004, median difference 110 under the null hypothesis of no association between sex and phenotype). The repeated subsample analysis also showed significantly more interview-symptom phenotypes in women than men (206.8±7.3 versus 188.6±6.0, P<0.001). Women were more broadly distributed among symptom phenotype subgroups than men (P<0.001). Similar findings were observed in the analysis of symptoms abstracted from the medical record.ConclusionsWomen exhibited substantially more variation in unique symptom phenotypes than men, regardless of whether the symptoms were derived from structured interviews or abstracted from the medical record. These findings may provide an explanation for the higher missed diagnosis rate in young women with AMI and may have important implications for teaching and improving clinicians' ability to recognize the diagnosis of AMI in women.

Dataset Information

Sex differences in the effectiveness of statins after myocardial infarction.

Background

Methods

Results

Interpretation

Publications

Sex differences in the effectiveness of statins after myocardial infarction.

Similar Datasets

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