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Type: Journal article
Title: Age-specific gender differences in early mortality following ST-segment elevation myocardial infarction in China
Author: Zheng, X.
Dreyer, R.
Hu, S.
Spatz, E.
Masoudi, F.
Spertus, J.
Nasir, K.
Li, X.
Li, J.
Wang, S.
Krumholz, H.
Jiang, L.
Citation: Heart, 2015; 101(5):349-355
Publisher: BMJ Publishing Group
Issue Date: 2015
ISSN: 1355-6037
Statement of
Xin Zheng, Rachel P Dreyer, Shuang Hu, Erica S Spatz, Frederick A Masoudi, John A Spertus, Khurram Nasir, Xi Li, Jing Li, Sisi Wang, Harlan M Krumholz, Lixin Jiang, for the China PEACE Collaborative Group
Abstract: Objective: To assess whether younger, but not older, women in China have higher in-hospital mortality following ST-Segment Elevation Myocardial Infarction (STEMI) compared with men, and whether this relationship varied over the last decade or across rural/urban areas. Methods; We analysed a nationally representative sample of 11 986 patients with STEMI from 162 Chinese hospitals in 2001, 2006 and 2011, in the China PEACE-Retrospective AMI Study and compared in-hospital mortality between women and men with gender–age interactions in multivariable models. Results: The overall in-hospital mortality rate was higher in women compared with men (17.2% vs 9.1%, p<0.0001; unadjusted OR 2.07, 95% CI 1.85 to 2.33). The unadjusted OR for mortality in women, compared with men, was 2.20 (95% CI 1.59 to 3.04), 2.21 (95% CI 1.74 to 2.79), 1.37 (95% CI 1.15 to 1.65) and 1.25 (95% CI 0.97 to 1.63) for ages <60, 60–69, 70–79 and ≥80 years, respectively. After adjustment for patient characteristics, hospital characteristics and year of study, the OR for mortality comparing women with men was 1.69 (95% CI 1.01 to 2.83), 1.64 (95% CI 1.24 to 2.19), 1.15 (95% CI 0.90 to 1.46) and 0.82 (95% CI 0.60 to 1.11) for ages <60, 60–69, 70–79 and ≥80 years, respectively. The gender–age interaction for mortality was statistically significant (p=0.009), even after adjustment for a wide range of confounders, and did not vary over time or across rural/urban areas. Conclusions: Among a Chinese population with STEMI, gender differences in early mortality were age-dependent and greatest in the younger groups <70 years of age.
Keywords: Percutaneous Coronary Intervention
Rights: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
RMID: 0030084121
DOI: 10.1136/heartjnl-2014-306456
Appears in Collections:Medicine publications

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