Myocardial infarction in women: A critical appraisal of gender differencesin outcomes

In every year since 1984, cardiovascular disease has claimed the lives of m ore women than men. Data from randomized trials indicate that gender contri butes to increased mortality after myocardial infarction independent of oth er risk factors, but additional confounding variables cannot be discounted. Data from registry databases indicate that women are less likely to receiv e medically proven therapies for myocardial infarction, Women experience mo re vague symptoms, which may account for underuse of effective therapies. I n addition, they may benefit less from thrombolytic therapy than men. Incre ased use of thrombolytic therapy has resulted in a continued decrease in ca rdiovascular deaths for men, but not for women. It is unclear if this dispa rity is a result of inequitable access to therapy or decreased efficacy of these agents in women.