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Sex differences in survival and mana...
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Vaccarino, Laura Viola.
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Sex differences in survival and management after myocardial infarction in the elderly.
紀錄類型:
書目-電子資源 : Monograph/item
正題名/作者:
Sex differences in survival and management after myocardial infarction in the elderly./
作者:
Vaccarino, Laura Viola.
面頁冊數:
211 p.
附註:
Source: Dissertation Abstracts International, Volume: 56-03, Section: B, page: 1368.
Contained By:
Dissertation Abstracts International56-03B.
標題:
Health Sciences, Public Health. -
電子資源:
http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=9523247
Sex differences in survival and management after myocardial infarction in the elderly.
Vaccarino, Laura Viola.
Sex differences in survival and management after myocardial infarction in the elderly.
- 211 p.
Source: Dissertation Abstracts International, Volume: 56-03, Section: B, page: 1368.
Thesis (Ph.D.)--Yale University, 1994.
Studies of sex differences in outcome and treatment after myocardial infarction have reported conflicting results, possibly for differences in baseline characteristics between men and women. The aim of this study was to examine sex differences in survival and management after myocardial infarction in a group of women and men aged 65 and older for whom detailed clinical, sociodemographic and physical function data was collected, and who were part of a population-based study, the Established Populations for the Epidemiologic Study of the Elderly (EPESE) program.Subjects--Topical Terms:
1017659
Health Sciences, Public Health.
Sex differences in survival and management after myocardial infarction in the elderly.
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Source: Dissertation Abstracts International, Volume: 56-03, Section: B, page: 1368.
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Advisers: Lisa F. Berkman; Ralph I. Horwitz.
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Studies of sex differences in outcome and treatment after myocardial infarction have reported conflicting results, possibly for differences in baseline characteristics between men and women. The aim of this study was to examine sex differences in survival and management after myocardial infarction in a group of women and men aged 65 and older for whom detailed clinical, sociodemographic and physical function data was collected, and who were part of a population-based study, the Established Populations for the Epidemiologic Study of the Elderly (EPESE) program.
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In unadjusted analysis, there were no statistically significant differences in 30-day mortality between 115 men and 98 women who were hospitalized for myocardial infarction and were found to meet standard diagnostic criteria for myocardial infarction. However, after taking into account women's older age, lower functional status, and delayed hospital arrival, women were at half the risk of dying at 30-days compared to men. Addition of infarction severity to the analysis did not change materially the results. Among 166 hospital survivors, women were significantly less likely to die at 1 year post-discharge in univariate analysis, and after multivariable analysis, women's protection became even stronger.
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Similar proportions of women and men received coronary angiography and revascularization in the first 30 days. After controlling for age, admission year, infarction severity, comorbidity, hospital complications, and income, there were still no significant sex differences in the use of coronary angiography. Similar proportions of women and men also received aspirin and beta-blockers at the time of hospital discharge. After multivariable analysis, women received these medications about 35% less than men, but this difference did not reach statistical significance.
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The results of this study indicate that, among elderly myocardial infarction patients, women show an improved survival compared to men, which, in the early phase, is masked by women's later hospital arrival and higher prevalence of physical disability. Women's survival advantage after myocardial infarction is not due to differences in comorbidity, infarction severity, or treatment, but may reflect women's longer life expectancy in the general population. This study also indicates that among elderly women and men there are no important differences in treatment after myocardial infarction.
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