Gender differences in recurrent coronary events - The FINMONICA MI register

Background Male gender is an established risk factor for first myocardial i nfarction, but some studies have suggested that among myocardial infarction survivors, women fare worse than men. Therefore, we examined the long-term prognosis of incident myocardial infarction survivors in a large, populati on-based MI register, addressing gender differences in mortality as well as the number of events and time intervals between recurrent events. Methods and Results Study subjects included 4900 men and women, aged 25-64 years, with definite or probable first myocardial infarctions who were aliv e 28 days after the onset of symptoms. At first myocardial infarction, wome n were older and more likely to be hypertensive or diabetic than men, and h ad a greater proportion of probable vs definite events. After adjustment fo r age and geographic region, men had 1.74 times the risk of fatal coronary heart disease relative to women (hazard ratio = 1.63 and 1.55 for cardiovas cular disease and all-cause mortality, respectively) over an average of 5.9 years of follow-up. Number and time intervals between any recurrent event - fatal and non-fatal - did not differ by gender. Conclusion These data suggest that men are far more likely to have a fatal recurrent event than women despite comparable numbers of events. (Eur Heart J 2001; 22: 762-768, doi:10.1053/euhj.2000.2501) (C) 2001 The European Soc iety of Cardiology.