%0 Journal Article
%T Better long-term survival in young and middle-aged women than in men after a first myocardial infarction between 1985 and 2006. an analysis of 8630 patients in the Northern Sweden MONICA Study
%A Rose-Marie Isaksson
%A Jan-H£¿kan Jansson
%A Dan Lundblad
%A Ulf N£¿slund
%A Karin Zingmark
%A Mats Eliasson
%J BMC Cardiovascular Disorders
%D 2011
%I BioMed Central
%R 10.1186/1471-2261-11-1
%X The Northern Sweden MONICA Myocardial Infarction Registry was linked to The Swedish National Cause of Death Registry for a total of 8630 patients, 25 to 64 years of age, 6762 men and 1868 women, with a first MI during 1985-2006. Also deaths before admission to hospital were included. Follow-up ended on August 30, 2008.Median follow-up was 7.1 years, maximum 23 years and the study included 70 072 patient-years. During the follow-up 45.3% of the men and 43.7% of the women had died. Median survival for men was 187 months (95% confidence interval (CI) 179-194) and for women 200 months (95% CI 186-214). The hazard ratio (HR) for all cause mortality after adjustment for age group was 1.092 (1.010-1.18, P = 0.025) males compared to females, i.e. 9 percent higher survival in women. After excluding subjects who died before reaching hospital HR declined to 1.017 (95%CI 0.93-1.11, P = 0.7). For any duration of follow-up a higher proportion of women were alive, irrespective of age group. The 5-year survivals were 75.3% and 77.5%, in younger (<57 years) men and women and were 65.5% and 66.3% in older (57-64 years) men and women, respectively. For each of four successive cohorts survival improved. Survival time was longer for women than for men in all age groups.Age-adjusted survival was higher among women than men after a first MI and has improved markedly and equally in both men and women over a 23-year period. This difference was due to lower risk for women to die before reaching hospital.Mortality from myocardial infarction (MI) in Sweden, as in most other developed countries, has decreased markedly during recent decades[1]. The international MONICA collaboration hypothesizes that the decline is mainly due to a decrease in the classical risk factors -- smoking, cholesterol and blood pressure [2], although recent modelling strongly emphasizes the pivotal role of lower cholesterol [3]. However, MI still remains the most common cause of death in Sweden and other western regions
%U http://www.biomedcentral.com/1471-2261/11/1