[Acute myocardial infarction in Chile: differences between men and women in its evolution and prognosis. Multicenter Study Group on Infarction] (GEMI)].

BACKGROUND: Gender may be a prognostic factor for the evolution of acute myocardial infarction and women may have higher mortality and complication rates. AIM: To study if there are differences in the evolution of acute myocardial infarction between men and women. PATIENT AND METHODS: We have recorded information on risk factors, clinical evolution, treatment and complications of 2,052 patients hospitalized for acute myocardial infarction in 36 Chilean hospitals. The odds ratio for female sex and mortality was calculated using a logistic regression analysis adjusted for risk factors, treatment, invasive procedures and complications. RESULTS: Twenty six percent of analyzed patients were female. Mortality rates among females and males were 11.8 and 20.2% respectively (p < 0.01). Women had higher frequency of smoking, diabetes, obesity and hypertension. Blood lipid levels were similar in both sexes. Compared to men, a lesser proportion of women were treated with thrombolytic agents (25 and 35% respectively), intravenous heparin (54 and 61% respectively), beta blockers (31 and 42% respectively) and intravenous nitrates (53 and 61% respectively). Also, women were subjected to less invasive procedures. The odds ratio for mortality and sex was 1.72 (confidence interval from 1.13 to 2.62). CONCLUSIONS: Female sex is an independent risk factor for acute myocardial infarction mortality.