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Sex-related Outcome Differences after Acute Myocardial Infarction
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
We were intrigued by the study of Becker and colleagues [1], who showed higher morbidity and mortality rates in women than in men after acute myocardial infarction treated with thrombolytic agents. Older age at the time of myocardial infarction and higher prevalence of diabetes mellitus, hypertension, and previous heart failure in women did not completely explain the observed sex difference in clinical outcomes. These clinical characteristics suggest that left ventricular hypertrophy might be more prevalent in women and may partially explain the differences.
Recent data have established left ventricular hypertrophy as a powerful independent predictor of cardiovascular complication and death from all causes in patients with and without coronary artery disease [2]. Data from canine models of acute myocardial infarction show that left ventricular hypertrophy, especially in dogs with hypertension, leads to a more rapid progression of myocardial necrosis [3], larger infarction size [4], and as much as a fourfold increase in mortality. Bolognese and associates [5] recently showed that in uncomplicated, acute myocardial infarction associated with single-vessel coronary artery disease, the left ventricular mass index is the only independent predictor of cardiac events. Previous studies that showed adverse clinical outcomes in women who received thrombolytic therapy for acute myocardial infarction, however, did not evaluate baseline differences in left ventricular mass. We wonder whether differences in the prevalence of left ventricular hypertrophy (using sex-specific criteria) might explain most the observed sex difference in clinical outcomes.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
