Women and Acute Coronary Syndromes

  • Alice K. Jacobs
Part of the Contemporary Cardiology book series (CONCARD)


Cardiovascular disease remains the leading cause of death in women in the United States and claims the lives of approximately 500,000 women annually (1). In addition, despite an overall reduction in the death rate due to cardiovascular disease in this country, the rate of decline is less for women than for men, and, due to an aging population, the absolute number of deaths due to cardiovascular disease has actually increased in women (2). During the past several years, with the focus on women’s health in general and heart disease in women in particular, there is an increased awareness of the problem. Thus the management of women with coronary heart disease has come under close scrutiny, and gender differences in the presentation, evaluation, access to care, management, and acute and long-term outcome of patients with acute coronary syndromes has been under active investigation.


Acute Coronary Syndrome Acute Myocardial Infarction Unstable Angina Thrombolytic Therapy Coronary Angioplasty 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    American Heart Association. 1997 Heart and Stroke Facts: Statistical Update. American Heart Association, Dallas, TX, 1996.Google Scholar
  2. 2.
    Mosca L, Manson JE, Sutherland SE, Langer RD, Manolio T, Barrett-Connor E. Cardiovascular disease in women: a statement for healthcare professionals from the American Heart Association. Circulation. 1997; 96: 2468–2482.PubMedCrossRefGoogle Scholar
  3. 3.
    Castelli WP. Cardiovascular disease in women. Am J Obstet Gynecol 1988; 138: 1553–1560.CrossRefGoogle Scholar
  4. 4.
    Kannel WB, Sorlie P, McNamara PM. Prognosis after initial myocardial infarction: the Framingham study. Am J Cardiol 1979; 44: 53–59.PubMedCrossRefGoogle Scholar
  5. 5.
    Kannel WB. Hypertension, hypertrophy, and the occurrence of cardiovascular disease. Am J Med Sci 1991; 302: 199–204.PubMedCrossRefGoogle Scholar
  6. 6.
    Surveillance for selected tobacco use behaviors-United States, 1900–1994. MMWR 1994; 43: 1–43.Google Scholar
  7. 7.
    Lerner DJ, Kannel WB. Patterns of coronary heart disease morbidity and mortality in the sexes: a 26 year follow-up of the Framingham population. Am Heart J 1986; 111: 383–390.PubMedCrossRefGoogle Scholar
  8. 8.
    Welch CC, Proudfit WL, Sheldon WC. Coronary arteriographic findings in 1,000 women under age 50. Am J Cardiol. 1975; 35: 211–215.PubMedCrossRefGoogle Scholar
  9. 9.
    Waters DD, Halphen C, Theroux P, David PR, Mizgala HF. Coronary artery disease in young women: clinical and angiographic features and correlation with risk factors. Am J Cardiol 1978; 42: 41–47.PubMedCrossRefGoogle Scholar
  10. 10.
    Chaitman Br, Bourassa MG, Davis K, Rogers WJ, Tyras DH, Berger R, et al. Angiographic prevalence of high-risk coronary artery disease in patient subsets (CASS). Circulation 1981; 64: 360–367.PubMedCrossRefGoogle Scholar
  11. 11.
    Reddy KG, Nair RN, Sheehan HM, Hodgson JM. Evidence that selective endothelial dysfunction may occur in the absence of angiographic or ultrasound atherosclerosis in patients with risk factors for atherosclerosis. J Am Coll Cardiol 1994; 23: 833–843.PubMedCrossRefGoogle Scholar
  12. 12.
    Reis SE, Gloth ST, Blumenthal RS Resar JR, Zacur HA, Gerstenblith G, et al. Ethinyl estradiol acutely attenuates abnormal coronary vasomotor responses to acetylcholine in postmenopausal women. Circulation 1994; 89: 52–60.PubMedCrossRefGoogle Scholar
  13. 13.
    Weiner DA, Ryan TJ, McCabe CH, Kennedy JW, Schloss M, Tristani F, et al. Exercise stress testing: correlations among history of angina, ST-segment response,and prevalence of coronary artery disease in the Coronary Artery Surgery Study (CASS). N Engl J Med 1979; 301: 230–235.PubMedCrossRefGoogle Scholar
  14. 14.
    Friedman T, Greene A, Iskandrian A, Hakki AH, Kane S, Segal B. Exercise thallium-201 myocardial scintigraphy in women: correlation with coronary angiography. Am J Cardiol 1982; 49: 1632 1637.Google Scholar
  15. 15.
    Marwick TH, Anderson T, Williams MJ, Haluski B, Melia JA, Pashkow F, et al. Exercise echocardiography is an accurate and cost-efficient technique for detection of coronary artery disease in women. J Am Coll Cardiol 1995; 26: 335–341.PubMedCrossRefGoogle Scholar
  16. 16.
    Baptista J, Arnese M, Roelandt JRTC, Fioretti P, Keane D, Escaned J, et al. Quantitative coronary angiography in the estimation of the functional significance of coronary stenosis: correlations with dobutamine-atropine stress test. Am Coll Cardiol 1994; 23: 1434–1439.CrossRefGoogle Scholar
  17. 17.
    Patterson RE, Churchwell KB, Eisner RL. Diagnosis of coronary artery disease in women: roles of three dimensional imaging with magnetic resonance or positron emission tomography. Am J Cardiac Imaging 1996; 10: 78–88.Google Scholar
  18. 18.
    Steingart RM, Packer M, Hamm P, Coglianese ME, Gersh B, Geltman EM, et al. Sex differences in the management of coronary artery disease. N Engl J Med 1991; 325: 226–230.PubMedCrossRefGoogle Scholar
  19. 19.
    Ayanian JZ, Epstein AM. Differences in the use of procedures between women and men hospitalized for coronary heart disease. N Engl J Med 1991; 325: 221–225.PubMedCrossRefGoogle Scholar
  20. 20.
    Tobin JN, Wassertheil-Smoller S, Wexler JP, Steingart RM, Budner N, Lense L, et al. Sex bias in considering coronary bypass surgery. Ann Intern Med 1987; 107: 19–25.PubMedCrossRefGoogle Scholar
  21. 21.
    Maynard C, Beshansky JR, Griffith JL, Selker HP. Influence of sex on the use of cardiac procedures in patients presenting to the emergency department. A prospective multicenter study. Circulation 1996;94(suppl):II-93–98.Google Scholar
  22. 22.
    Schecter AD, Goldschmidt-Clermont PJ, McKee G, Hoffeld D, Myers M, Velez R, et al. Influence of gender, race, and education on patient preferences and receipt of cardiac catheterizations among coronary care unit patients. Am J Cardiol 1996; 78: 996–1001.PubMedCrossRefGoogle Scholar
  23. 23.
    Bell MR, Berger PB, Holmes DR Jr, Mullany CJ, Bailey KR, Gersh BJ. Referral for coronary artery revascularization procedures after diagnostic coronary angiography: evidence for gender bias? Am Coll Cardiol 1995; 25: 1650–1655.CrossRefGoogle Scholar
  24. 24.
    Bernstein SJ, Hilborne LH, Leape LL, Park RE, Brook RH. The appropriateness of use of cardiovascular procedures in women and men. Arch Intern Med 1994; 154: 2759–2768.PubMedCrossRefGoogle Scholar
  25. 25.
    Mark DB, Shaw LK, De Long ER, Califf RM, Pryor DB. Absence of sex bias in the referral of patients for cardiac catheterization. N Engl J Med 1994; 330: 1101–1106.PubMedCrossRefGoogle Scholar
  26. 26.
    Philippides GJ, Jacobs AK. Coronary angioplasty and surgical revascularization: emerging concepts. Cardiology 1995; 86: 324–338.PubMedCrossRefGoogle Scholar
  27. 27.
    Jacobs AK, Kelsey SF, Wanlin Y, Holmes DR Jr, Block PC, Cowley MJ, et al. Documentation of decline in morbidity in women undergoing coronary angioplasty (a report from the 1993–94 NHLBI Percutaneous Transluminal Coronary Angioplasty Registry). Am J Cardiol 1997; 80: 979–984.PubMedCrossRefGoogle Scholar
  28. 28.
    Weintraub WS, Wenger NK, Jones EL, Craver JM, Guyton RA. Changing clinical characteristics of coronary surgery patients: differences between men and women. Circulation 1993; 88: 79–86.Google Scholar
  29. 29.
    O’Connor GT, Morton JR, Diehl MJ, Olmstead EM, Coffin LH, Levy DG, et al. Differences between men and women in hospital mortality associated with coronary artery bypass graft surgery. Circulation 1993; 88: 2104–2110.PubMedCrossRefGoogle Scholar
  30. 30.
    Khan SS, Nessim S, Gray R, Czer LS, Chanx A, Matloff J. Increased mortality of women in coronary artery bypass surgery: evidence for referral bias. Ann Intern Med 1990; 112: 561–567.PubMedCrossRefGoogle Scholar
  31. 31.
    Tyras DH, Barner HB, Kaiser GC, Codd JE, Laks H, Wilman VL. Myocardial revascularization in women. Ann Thorac Surg 1978; 25: 449–453.PubMedCrossRefGoogle Scholar
  32. 32.
    Douglas JS, King SB III, Jones EL, Craver JM, Bradford JM, Hatcher CR. Reduced efficacy of coronary bypass surgery in women. Circulation 1981; 64: (suppl II): 11–16.Google Scholar
  33. 33.
    Loop FD, Golding LR, MacMillan JP, Cosgrove DM, Lytle BW, Sheldon WC. Coronary artery surgery in women compared with men: analysis of risks and long-term results. J Am Coll Cardiol 1983; 1: 383–390.PubMedCrossRefGoogle Scholar
  34. 34.
    Cowley MJ, Mulin MS, Kelsey SF, Kent MK, Gruentzig AR, Detre KM, et al. Sex differences in early and long-term results of coronary angioplasty in the NHLBI PTCA Registry. Circulation 1985; 71: 9097.CrossRefGoogle Scholar
  35. 35.
    McEniery PT, Hollman J, Knezinek V, Dorosti K, Franco I, Simpfendorfer C, et al. Comparative safety and efficacy of percutaneous transluminal coronary angioplasty in men and women. Cathet Cardiovasc Diagn 1987; 13: 364–371.PubMedCrossRefGoogle Scholar
  36. 36.
    Kelsey SF, James M, Holubkov AL, Holubkov B, Cowley MJ, Detre KM. Results of percutaneous transluminal coronary angioplasty in women: 1985–1986 National Heart, Lung and Blood Institute’s Coronary Angioplasty Registry. Circulation 1993; 87: 720–727.PubMedCrossRefGoogle Scholar
  37. 37.
    Bell MR, Holmes DR Jr, Berger PB, Ganatl KN, Bailey KR, Gersh BJ. The changing in-hospital mortality of women undergoing percutaneous transluminal coronary angioplasty. JAMA 1993; 269: 2091–2095.PubMedCrossRefGoogle Scholar
  38. 38.
    Kahn JK, Ruterford BD, McConahay DR, Johnson WL, Giorgi LV, Shimshak TM, et al. Comparison of procedural results and risks of coronary angioplasty in men and women for conditions other than myocardial infarction. Am J Cardiol 1992; 69: 1241–1242.PubMedCrossRefGoogle Scholar
  39. 39.
    Malenka DJ, O’Connor GT, Quinton H, Wennberg D, Robb JF, Shubrooks S, et al. Differences in outcomes between women and men associated with percutaneous transluminal coronary angioplasty. A regional prospective study of 13061 procedures. Circulation 1996; 94: (suppl II): 99–104.Google Scholar
  40. 40.
    Welty FK, Mittleman MA, Healy RW, Muller JE, Shubrooks SJ Jr. Similar results of percutaneous transluminal coronary angioplasty for women and men with postmyocardial infarction ischemia. J Am Coll Cardiol 1994; 23: 35–39.PubMedCrossRefGoogle Scholar
  41. 41.
    Eysmann SB, Douglas PS. Reperfusion and revascularization strategies for coronary artery disease in women. JAMA 1992; 268: 1903–1907.PubMedCrossRefGoogle Scholar
  42. 42.
    Stone GW, Grines CL, Browne KF, Marco J, Rothbaum D, O’Keefe J, et al. Comparison of in-hospital outcome in men versus women treated by either thrombolytic therapy or primary coronary angioplasty for acute myocardial infarction. Am J Cardiol 1995; 75: 987–992.PubMedCrossRefGoogle Scholar
  43. 43.
    Davis KB, Chaitman B, Ryan T, Bittner V, Kennedy WJ. Comparison of 15 year survival for men and women after initial medical or surgical treatment for coronary artery disease: a CASS registry study. J Am Coll Cardiol 1995; 25: 1000–1009.PubMedCrossRefGoogle Scholar
  44. 44.
    Mendes LA, Davidoff R, Cupples LA, Ryan TJ, Jacobs AK. Congestive heart failure in patients with coronary artery disease: the gender paradox. Am Heart J 1997; 134: 207–212.PubMedCrossRefGoogle Scholar
  45. 45.
    Davies MJ. The composition of coronary-artery plaques. N Engl J Med 1997; 336: 1312–1314.PubMedCrossRefGoogle Scholar
  46. 46.
    Mautner L, Lin F, Mautner CG, Roberts WC. Comparison in women versus men of composition of atherosclerotic plaques in native coronary arteries and in saphenous veins used as aortocoronary conduits. J Am Coll Cardiol 1993; 21: 1312–1318.PubMedCrossRefGoogle Scholar
  47. 47.
    Roberts CS, Roberts WC. Cross-sectional area of the proximal portions of the three major epicardial coronary arteries in 98 necropsy patients with different coronary events: relationship to heart weight, age, and sex. Circulation 1980; 62: 953–959.PubMedCrossRefGoogle Scholar
  48. 48.
    Hannan EL, Bernard R, Kilburn HC Jr, O’ Donnel JF. Gender differences in mortality rates for coronary artery bypass surgery. Am Heart J 1992; 123: 866–872.PubMedCrossRefGoogle Scholar
  49. 49.
    Jacobs AK, Kelsey SF, Brooks MM, Faxon DP, Chaitman BR, Bittner V, et al. Better outcome for women as compared to men undergoing coronary revascularization: a report from the Bypass Angioplasty Revascularization Investigation (BARI). Circulation 1998; in press.Google Scholar
  50. 50.
    Schaff HV, Rosen AD, Shemin RJ, Leclerc Y, Wareing TH, Aguirre FV, et al. Clinical and operative characteristics of patients randomized to coronary artery bypass surgery in the bypass angioplasty revascularization investigation (BARI). Am J Cardiol 1995; 75: 180–26C.CrossRefGoogle Scholar
  51. 51.
    Fisher LD, Kennedy JW, Davis KB, Maynard C, Fritz JK, Kaiser G, et al. Association of sex, physical size, and operative mortality after coronary artery bypass in the Coronary Artery Surgery Study (CASS). J Thorac Cardiovasc Surg 1982; 84: 334–341.PubMedGoogle Scholar
  52. 52.
    Christakis GT. Weisel RD, Buth KJ, Fremes SE, Rao V, Panagiotopoulos KP, et al. Is body size the cause for poor outcomes of coronary artery bypass operations in women? J Thorac Cardiovasc Surg 1995; 110: 1344–1356.PubMedCrossRefGoogle Scholar
  53. 53.
    Hammar N, Sandberg E, Larsen FF, Ivert T. Comparison of early and late mortality in men and women after isolated coronary artery bypass graft surgery in Stockholm, Sweden, 1980–1989. J Am Coll Cardiol 1997; 29: 659–664.PubMedCrossRefGoogle Scholar
  54. 54.
    Mickelborough LL, Takagi Y, Maruyama H, Sun Z, Mohamed S. Is sex a factor in determining operative risk for aortocoronary bypass graft surgery? Circulation 1995;92 (suppl):II-80–84.Google Scholar
  55. 55.
    Greenberg MA, Mueller HS. Why the excess mortality in women after PTCA? Circulation 1993; 87: 1030–1032.PubMedCrossRefGoogle Scholar
  56. 56.
    Robertson T, Kennard ED, Mehta S, Popma JJ, Carrozza JP Jr, King SB III, et al. Influence of gender on in-hospital clinical and angiographic outcomes and on one-year follow-up in the new approaches to coronary intervention (NACI) registry. Am J Cardiol 1997; 80: 26K - 39K.PubMedCrossRefGoogle Scholar
  57. 57.
    Fishman RF, Kintz RE, Carrozza JP Jr, Friedrich SP, Gordon PC, Senerchia CC, et al. Acute and long-term results of coronary stents and atherectomy in women and the elderly. Coron Artery Dis 1995; 6: 159–168.PubMedCrossRefGoogle Scholar
  58. 58.
    Oweida SW, Roubin GS, Smith RB, Salam AA. Post-catheterization vascular complications associated with percutaneous transluminal coronary angioplasty. J Vasc Surg 1990; 12: 310–315.PubMedGoogle Scholar
  59. 59.
    Rahimtoola SH, Bennett AJ, Grunkemeier GL, Block P, Starr A. Survival at 15 to 18 years after coronary bypass surgery for angina in women. Circulation 1993; 88: 71–78.Google Scholar
  60. 60.
    Faker ED, Kronmal R, Kennedy JW, Davis K. Comparison of the long-term, postsurgical survival of women and men in the Coronary Artery Surgery Study (CASS). Am Heart J 1989; 117: 71–81.CrossRefGoogle Scholar
  61. 61.
    Philippides GJ, Jacobs AK. Coronary angioplasty in women: is there an increased risk? Cardiol Rev 1994; 2; 189–198.CrossRefGoogle Scholar
  62. 62.
    Ruygrok PN, deJaegere PP, van Domburg RT, van den Brand MJ, Serruys PW, deFeyter PJ. Women fare no worse than men 10 years after attempted coronary angioplasty. Cathet Cardiovasc Diagn 1996; 39: 9–15.PubMedCrossRefGoogle Scholar
  63. 63.
    Bell MR, Grill DE, Garratt KN, Berger PB, Gersh BJ, Holmes DR Jr. Long-term outcome of women compared with men after successful coronary angioplasty. Circulation 1995; 91: 2876–2881.PubMedCrossRefGoogle Scholar
  64. 64.
    Keelan ET, Nunez BD, Grille DE, Berger PB, Holmes DR Jr, Bell MR. Comparison of immediate and long-term outcome of coronary angioplasty performed for unstable angina and rest pain in men and women. Mayo Clin Proc 1997; 72: 5–12.PubMedCrossRefGoogle Scholar
  65. 65.
    Stone PH, Thompson B, Anderson HV, Kronenberg MW, Gibson RS, Rogers WJ, et al. Influence of race, sex, and age on management of unstable angina and non-Q-wave myocardial infarction. JAMA 1996; 275: 1104–1112.PubMedCrossRefGoogle Scholar
  66. 66.
    Goldschmidt-Clermont Pi, Schulman SP, Bray PF, Chandra NC, Grigoryev D, Dise KR, et al. Refining the treatment of women with unstable angina-a randomized, double-blind, comparative safety and efficacy evaluation of Integrelin versus aspirin in the management of unstable angina. Clin Cardiol 1996; 19: 869–874.PubMedCrossRefGoogle Scholar
  67. 67.
    Dittrick H, Glipin E, Nicod P, Cali G, Henning H, Ross J Jr. Acute myocardial infarction in women: influence of gender on mortality and prognostic variables. Am J Cardiol 1988; 62: 1–7.CrossRefGoogle Scholar
  68. 68.
    Becker RC, Terrin M, Ross R, Knatterud GL, Desvigne-Nickens P, Gore JM, et al. Comparison of clinical outcomes for women and men after acute myocardial infarction: the Thrombolysis in Myocardial Infarction Investigators. Ann Intern Med 1994; 120: 638–645.PubMedCrossRefGoogle Scholar
  69. 69.
    Toffler GH, Stone PH, Muller JE, Willich SN, Davis VG, Poole WK, et al. Effects of gender and race on prognosis after myocardial infarction: adverse prognosis for women, particularly black women. J Am Col Cardiol 1987; 9: 473–482.CrossRefGoogle Scholar
  70. 70.
    Kobert L, Torp-Pedersen C, Ottesen M, Rasmussen S, Lessing M, Skagen K. Influence of gender on short and long-term mortality after acute myocardial infarction. TRACE study group. Am J Cardiol 1996 77: 1052–1056.CrossRefGoogle Scholar
  71. 71.
    Greenland P, Reicher-Reiss H, Goldbourt U, Behar S, the Israeli SPRINT Investigators. In-hospital and 1-year mortality in 1,524 women after myocardial infarction: comparison with 4,315 men. Circulation 1991; 83: 484–491.PubMedCrossRefGoogle Scholar
  72. 72.
    Behar S, Boyko V, Reicher-Reiss H, Goldbourt U. Ten-year survival after acute myocardial infarction: comparison of patients with and without diabetes. SPRINT Study Group. Secondary Prevention Reinfarction Israeli Nifedipine Trial. Am Heart J 1997; 133: 290–296.PubMedCrossRefGoogle Scholar
  73. 73.
    Donahue RP, Goldberg RJ, Chen Z, Gore JM, Alpert JS. The influence of sex and diabetes mellitus on survival following acute myocardial infarction: a community-wide perspective. J Clin Epidemiol 1993; 46: 245–252.PubMedCrossRefGoogle Scholar
  74. 74.
    Feibach N, Viscoli CM, Horwitz RI. Difference between women and men in survival after myocardial infarction: biology or methodology? JAMA 1990; 263: 1092–1096.CrossRefGoogle Scholar
  75. 75.
    Vaccarino V, Krumholz HM, Berkman LF, Horwitz RI. Sex differences in mortality after myocardial infarction: is there evidence for an increased risk for women? Circulation 1995; 91: 1861–1871.PubMedCrossRefGoogle Scholar
  76. 76.
    Malacrida R, Genoni M, Maggioni AP, Spataro V, Parish S Palmer, A, et al. A comparison of the early outcome of acute myocardial infarction women and men. N Engl J Med 1998; 338: 8–14.PubMedCrossRefGoogle Scholar
  77. 77.
    Fibrinolytic Therapy Trialists (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomized trials of more than 1000 patients. Lancet 1995; 343: 311–322.Google Scholar
  78. 78.
    ISIS-4. A randomized factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. Lancet 1995; 345: 669–685.CrossRefGoogle Scholar
  79. 79.
    Weaver WD, White HD, Wilcox RG, Aylward PE, Morris D, Guerci A, et al. Comparisons of characteristics and outcomes among women and men with acute myocardial infarction treated with thrombolytic therapy. JAMA 1996; 275: 777–782.PubMedCrossRefGoogle Scholar
  80. 80.
    Maggioni AP, Franzosi MG, Szantoro E, White H, Van de Werf F, Tognoni G. The risk of stroke in patients with acute myocardial infarction after thrombolytic and antithrombotic treatment. Gruppo Italiano per to Studio della Sopravvivenza nell’ Infarto Miocardico II (GISSI-2), and The International Study Group. N Engl J Med 1992: 2; 327: 1–6.CrossRefGoogle Scholar
  81. 81.
    White HD, Barbash GI, Modan M, Simes J, Diaz R, Hampton JR, et al. After correcting for worse baseline characteristics, women treated with thrombolytic therapy for acute myocardial infarction have the same mortality and morbidity as men except for a higher incidence of hemorrhagic stroke. Circulation 1993; 88: 2097–2103.PubMedCrossRefGoogle Scholar
  82. 82.
    Maynard C, Althouse R, Cerqueira M, Osufka M, Kennedy WJ. Underutilization of thrombolytic therapy in eligible women with acute myocardial infarction. Am J Cardiol 1991; 68: 529–530.PubMedCrossRefGoogle Scholar
  83. 83.
    Kostis JB, Wilson AC, O’Dowd K, Gregory P, Chetson S, Cosgrove NM, et al. Sex differences in the management and long-term outcome of acute myocardial infarction: a statewide study. Circulation 1994; 90: 1715–1730.PubMedCrossRefGoogle Scholar
  84. 84.
    Oka RK, Fortmann SP, Varadu AN. Differences in treatment of acute myocardial infarction by sex, age, and other factors (the Stanford Five-City project). Am J Cardiol 1996; 78: 861–865.PubMedCrossRefGoogle Scholar
  85. 85.
    Chiriboga DE, Yarzebski J, Goldberg RJ, Chen Z, Gurwitz J, Gore JM, et al. A community-wide perspective of gender differences and temporal trends in the use of diagnostic and revascularization procedures for acute myocardial infarction. Am J Cardiol 1993; 71: 268–273.PubMedCrossRefGoogle Scholar
  86. 86.
    Pagley PR, Yarzebski J, Goldberg R, Chen Z, Chiriboga D, Dalen P, et al. Gender differences in the treatment of patients with acute myocardial infarction. A multihospital, community-based perspective. Arch Intern Med 1993; 153: 625–629.PubMedCrossRefGoogle Scholar
  87. 87.
    Krumholz H, Douglas PS, Lauer MS, Pastnernak RC. Selection of patients for coronary angiography and coronary revascularization early after myocardial infarction: is there evidence for a gender bias? Ann Intern Med 1992; 116: 785–790.PubMedCrossRefGoogle Scholar
  88. 88.
    Kostis JB, Wilson AC, O’Dowd K, Gregory P, Chelton S, Cosgrove NM, et al. Sex differences in the management and long-term outcome of acute myocardial infarction: a statewide study. MIDAS Study Group. Circulation 1994; 90: 1715–1730.PubMedCrossRefGoogle Scholar
  89. 89.
    Kundenchuk P, Maynard C, Martin J, Wirkus M, Weaver WD. Comparison of presentation, treatment, and outcome of acute myocardial infarction in men versus women (The Myocardial Infarction Triage and Intervention Registry). Am J Cardiol 1996; 78: 9–14.CrossRefGoogle Scholar
  90. 90.
    Weitzman S, Cooper L, Chambless L, Rosamond W, Clegg L, Marcucci G, et al. Gender, racial, and geographic differences in the performance of cardiac diagnostic and therapeutic procedures for hospitalized acute myocardial infarction in four states. Am J Cardiol 1997; 79: 722–726.PubMedCrossRefGoogle Scholar
  91. 91.
    Becker RC. Coronary thrombolysis in women. Cardiology 1990; 77 (suppl 2): 110–123.PubMedCrossRefGoogle Scholar
  92. 92.
    Woodfield SL, Lundergan CF, Reiner JS, Thompson MA, Rohrbeck SC, Deychak Y, et al. Gender and acute myocardial infarction: is there a different response to thrombolysis? J Am Coll Cardiol 29: 35–42.Google Scholar
  93. 93.
    Jackson RE, AndersonW, Peacock WF IV, Vaught L, Carley RS, Wislon AG. Effect of a patient’ s sex on the timing of thrombolytic therapy. Ann Emerg Med 1996 27: 8–15.PubMedCrossRefGoogle Scholar
  94. 94.
    Yarzebski J, Col N, Pagley P, Savageau J, Gore J, Goldberg R. Gender differences and factors associated with the receipt of thrombolytic therapy in patients with acute myocardial infarction: a community-wide perspective. Am Heart J 1996; 131: 43–50.PubMedCrossRefGoogle Scholar
  95. 95.
    Vacek JL, Handlin LR, Rosamond TL, Beauchamp G. Gender-related differences in reperfusion treatment allocation and outcome for acute myocardial infarction. Am J Cardiol 1995; 76: 226–229.PubMedCrossRefGoogle Scholar
  96. 96.
    Karnash SL, Granger CG, White HD, Woodlief LH, Topol EJ, Califf RM. Treating menstruating women with thrombolytic therapy: insights from the global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries (GUSTO-I) trial. J Am Coll Cardiol 1995; 26: 1651–1656.PubMedCrossRefGoogle Scholar
  97. 97.
    Lanter PL, Jennings CF, Roberts CS, Jesse RL. Safety of thrombolytic therapy in normally menstruating women with acute myocardial infarction. Am J Cardiol 1994; 74: 179–181.PubMedCrossRefGoogle Scholar
  98. 98.
    Antiplatelet Trialists’ Collaboration. Collaborative overview of randomized trails of antiplatelet therapy— I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ 1994; 308: 106.Google Scholar
  99. 99.
    LaRosa JC. Triglycerides and coronary risk in women and the elderly. Arch Intern Med 1997; 157: 961–968.PubMedCrossRefGoogle Scholar
  100. 100.
    Hochman JS, Boland J, Sleeper LA, Porway M, Brinker J, Col J, et al. Current spectrum of cardiogenic shock and effect of early revascularization in mortality: results of an international registry. Circulation 1995; 91: 873–881.PubMedCrossRefGoogle Scholar
  101. 101.
    Wong SC, Lin JE, Jiang X, Steingart R, Palozza AM, Jacobs AK, et al. Are there gender differences in clinical outcomes for patients with cardiogenic shock? A report from the SHOCK trial registry. Circulation 1997; 96: I - 534.Google Scholar
  102. 102.
    Vacek JL, Rosamond TL, Kramer PH, Crouse LJ, Porter CB, Robuck OW, et al. Sex-related differences in patients undergoing direct angioplasty for acute myocardial infarction. Am Heart J 1993; 126: 521–525.PubMedCrossRefGoogle Scholar
  103. 103.
    Hochman JS, McCabe CH, Stone PH, Becker RC, Cannon CP, DeFeo-Fraulini T, et al. Outcome and profile of women and men presenting with acute coronary syndromes: a report from TIMI IIIB. J Am Coll Cardiol 1997; 30: 141–148.PubMedCrossRefGoogle Scholar
  104. 104.
    Weintraub WS, Wenger NK, Kosinski AS, Douglas JS Jr, Liberman HA, Morris DC, et al. Percutaneous transluminal coronary angioplasty in women compared with men. J Am Coll Cardiol 1994; 24: 81–90.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Alice K. Jacobs

There are no affiliations available

Personalised recommendations