Abstract
Background and Objectives:The purpose of this study was to evaluate the age-related differences in clinical features, coronary anatomy, risk factors, hospital courses, and long-term prognosis of acute myocardial infarction (AMI in women. Materials and Methods:Total 513 female patients with AMI were divided into 3 groups; group 1 (n=43, 50 years old or less, group 2 (n=302, between 51 years and 70 years old, and group 3 (n= 168, older than 70 years. Clinical follow-up including cardiac events was performed for mean duration of 26 months (1-155 months. Cardiac events include cardiac death, reinfarction, CABG, PTCA, CHF, stroke, and recurrent angina. Results:Minimal lesion (<50% stenosis in infarct-related artery was more prevalent in group 1 than in group 3 (p<0.05. In group 2, the number of low high density lipoprotein (HDL was signific- antly more than in group 3 (p<0.01. During hospitalization, death and shock were more prevalently observed in group 3 than group 1 (p<0.005 and group 2 (p<0.001. Group 3 had more heart failures than group 1 (p<0. 001 and group 2 (p<0.001 and group 2 had more heart failures than group 1 (p<0.05. The younger age group showed a significantly higher survial rate (7 years:group 1;76.1%, group 2;60.6%, group 3;34.2%, p<0. 0001, Log Rank Stat=49.4 and cardiac event-free survival rate (7 years:group 1; 48.4%, group 2; 32. 3%, group 3;16.0%, p<0.0001, Log Rank Stat=37.5 for each 3 comparisons. In Cox proportional harzard analysis, LV systolic function influenced the group 2 survival (odds ratio 3.8, 95% CI 1.7 to 8.3, p<0.005 and the group 3 survival (odds ratio 2.2, 95% CI 1.1 to 4.5, p<0.05. The cardiac event free survival was influenced by age (odds ratio 1.6, 95% CI 1.2 to 2.1, p<0.005 and LV systolic function (odds ratio 1.8, 95% CI 1.3 to 2.5, p<0.001. Conclusion:Younger female patients with AMI had a more favorable prognosis compared with older female patients. LV systolic fuction was important as a prognostic factor for long-term survival except younger female AMI patients. ( ( ( (Korean Circulation J 2000;30( ( ( (10 :1245-1256
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