liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Impact of female sex on death and bleeding after fibrinolytic treatment of myocardial infarction in GUSTO V
Show others and affiliations
2007 (English)In: Archives of Internal Medicine, ISSN 0003-9926, E-ISSN 1538-3679, Vol. 167, no 19, 2054-2060 p.Article in journal (Refereed) Published
Abstract [en]

Background: Women with acute myocardial infarction are more likely than men to experience reinfarction, bleeding, or death. This difference has been hypothesized to be due to older age, treatment delay, and comorbidities in women. Use of diagnostic and therapeutic modalities may also differ. There is controversy regarding whether female sex is an independent risk factor for death and/or bleeding. Methods: The GUSTO (Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes) V Investigators studied standard-dose reteplase vs standard-dose abciximab plus half-dose reteplase in patients with myocardial infarction. Results: Women were older and more often had diabetes mellitus and hypertension. Angiography and percutaneous coronary intervention were less frequent in women. Death (9.8% vs 4.4% at 30 days, odds ratio [OR], 2.00, 95% confidence interval, 1.59-2.53,P < .001) and bleeding (6.4% vs 2.5%, OR, 1.31, 95% confidence interval, 1.18-1.45, P < .01) were more common in women. There was no association between treatment assignment and death in either sex, bleeding was more common in both sexes receiving combination therapy. Female sex was independently associated with mortality. After Killip class greater than 1 (OR, 4.7), female sex (OR, 2.0) was the strongest correlate of death. Female sex was independently associated with bleeding for both treatments. Conclusions: Female sex is independently associated with death and bleeding complications among fibrinolytic-treated patients with myocardial infarction. There remains a sex differential in the use of angiography and, therefore, percutaneous coronary intervention after fibrinolysis. Further research will determine what mediates excess risk in women. Trial Registration: Identifier: NCT00245648. ©2007 American Medical Association. All rights reserved.

Place, publisher, year, edition, pages
2007. Vol. 167, no 19, 2054-2060 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-41600DOI: 10.1001/archinte.167.19.2054Local ID: 58197OAI: diva2:262454
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2014-01-09Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Swahn, Eva
By organisation
Division of Cardiovascular MedicineFaculty of Health Sciences
In the same journal
Archives of Internal Medicine
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 42 hits
ReferencesLink to record
Permanent link

Direct link