ISSN:
1542-474X
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Objective: Although gender specificities of various risk factors have been well documented, risk stratification after myocardial infarction has never been compared in women and men.Methods: The power of left ventricular ejection fraction, heart rate variability, and mean RR interval computed from 24-hour Holter recordings, was compared in women and men for the prediction of cardiac mortality after an acute myocardial infarction. The study population consisted of 456 patients (108 women, 348 men) aged 50–75 years.Results: During a follow-up of 3 years, there were 41 cardiac deaths (13 women vs 28 men, P = NS). The positive predictive accuracy of left ventricular ejection fraction, heart rate variability, and mean RR interval at all sensitivity levels was higher in women than in men. For a 40% sensitivity, positive predictive accuracy of left ventricular ejection fraction was 46% in women and 16% in men (P 〈 0.05), positive predictive accuracy of mean RR interval was 90% in women and 28% in men (P 〈 0.05), and positive predictive accuracy of heart rate variability was 61% in women and 43% in men (P = NS). Mean RR interval had the highest positive predictive accuracy for cardiac mortality in women, but its superiority over heart rate variability was not statistically significant. In men, heart rate variability was the strongest predictor of mortality that was significantly more powerful than mean RR interval and left ventricular ejection fraction (P 〈 0.05).Conclusion: Increased 24-hour mean heart rate is the strongest predictor of cardiac mortality in women in whom it performs significantly better than in men. While in men, heart rate variability is a significantly better predictor of postinfarction cardiac mortality than 24-hour mean heart rate, this is not the case in women.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1542-474X.1997.tb00310.x
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