A national Survey of Acute Myocardial Infarction and Ischaemia (SAMII) in the UK: characteristics, management and in-hospital outcome in women compared to men in patients under 70 years

Aims To assess the clinical characteristics, management and outcome of wome n compared to men with acute myocardial infarction or ischaemia. Design A prospective clinical sun;ey was made in a random sample of 94 Dist rict General Hospitals in the U.K. 1064 patients, <70 pars of age, comprisi ng six consecutive females and six consecutive males from each hospital, di agnosed on admission as acute coronary syndromes (myocardial infarction or myocardial ischaemia) were studied. Outcome measures included: admission an d final diagnosis, time to delivery of care, inpatient management, complica tions and clinical outcome. Results Five hundred and three women and 561 men were admitted with a diagn osis of acute myocardial infarction or myocardial ischaemia. Women were old er, waited longer between seeking and receiving advice, and much less likel y to have infarction than men. After adjustment for age, diagnosis and past medical history there were no gender differences in initial and subsequent hospital management, in complications (recurrent ischaemia, arrhythmias, t emporary pacing, heart failure), any routine procedure or outcome, Of all p atients, 3.4% died in a District General Hospital, 12.2% were transferred t o Specialist Cardiac Centres and 84.4% discharged home. Prophylactic medica tion on discharge was similar for men and women. Conclusion After adjustment for age, diagnosis and past medical history, al though women waited longer between seeking and receiving medical advice, in hospital their assessment, management, complications, outcome and follow-u p arrangements were the same as for men. In hospital, management and outcom es were mainly influenced by age? diagnosis (infarction or ischaemia), a pa st history of coronary disease, but not by gender. This large, nationally r epresentative, survey has found no evidence of important gender difference in the hospital management of acute ischaemic syndromes. (C) 2000 The Europ ean Society of Cardiology.