GENDER DIFFERENCES IN THE PRESENTATION, TREATMENT, AND SHORT-TERM MORTALITY OF ACUTE CHEST PAIN

The Halifax County MONICA database was used to estimate the gender bia s in presentation, prehospital and in-hospital treatment, and 28-d mor tality of patients suffering an episode of acute chest pain. The study population consisted of all county residents aged 25-74, admitted bet ween 1984 and 1990 to a CCU, or suffering a myocardial infarction anyw here in a hospital. The mean age for men was 58.5 (n = 6561), for wome n 61.5 (n = 3176). Women of all age groups were more likely to have a history of diabetes or hypertension, and below age 55 had a higher pre valence of peripheral vascular disease. Typical symptoms for infarctio n were present in 30.8% of women and 38.1% of men (p < 0.0001). More w omen were taking beta-blockers, Ca-antagonists, digitalis, diuretics, and nitrates (p < 0.001), and more men were on antiarrhymics. A gender difference was observed for coronary arteriography (24% in men, 18% i n women) and for the exercise stress test (23% in men, 18% in women). In hospital, men had more episodes of severe arrhythmias (OR = 1.52). Except for aspirin and antiarrhythmics, the difference in hospital med ication and 28-d mortality (9.6% in women vs. 7.8% in men) could be ex plained by the existing clinical conditions.