Gender Differences in the Trajectory of Recovery in Health Status Among Young Patients With Acute Myocardial Infarction

Abstract

Background— Despite the excess risk of mortality in young women (≤55 years of age) after acute myocardial infarction (AMI), little is known about young women’s health status (symptoms, functioning, quality of life) during the first year of recovery after an AMI. We examined gender differences in health status over time from baseline to 12 months after AMI. Methods and Results— A total of 3501 AMI patients (67% women) 18 to 55 years of age were enrolled from 103 US and 24 Spanish hospitals. Data were obtained by medical record abstraction and patient interviews at baseline hospitalization and 1 and 12 months after AMI. Health status was measured by generic (Short Form-12) and disease-specific (Seattle Angina Questionnaire) measures. We compared health status scores at all 3 time points and used longitudinal linear mixed-effects analyses to examine the independent effect of gender, adjusting for time and selected covariates. Women had significantly lower health status scores than men at each assessment (all P values <0.0001). After adjustment for time and all covariates, women had Short Form-12 physical/mental summary scores that were −0.96 (95% confidence interval [CI], −1.59 to −0.32) and −2.36 points (95% CI, −2.99 to −1.73) lower than those of men, as well as worse Seattle Angina Questionnaire physical limitations (−2.44 points lower; 95% CI, −3.53 to −1.34), more angina (−1.03 points lower; 95% CI, −1.98 to −0.07), and poorer quality of life (−3.51 points lower; 95% CI, −4.80 to −2.22). Conclusion— Although both genders recover similarly after AMI, women have poorer scores than men on all health status measures, a difference that persisted throughout the entire year after discharge.