gms | German Medical Science

15. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

5. - 7. Oktober 2016, Berlin

The Impact of Gender on Current Trends and Management of Acute Myocardial Infarction – German Nationwide Data

Meeting Abstract

  • Eva Freisinger - Universitätsklinikum Münster, Abteilung für Angiologie, Department für Kardiologie und Angiologie, Münster, Deutschland
  • Susanne Sehner - Institute of Epidemiology, UKE Hamburg, Germany, Hamburg, Deutschland
  • Nasser Malyar - Universitätsklinikum Münster, Department für Kardiologie und Angiologie, Abteilung für Angiologie,, Münster, Deutschland
  • Anna Suling - Institute of Epidemiology, UKE Hamburg, Germany, Hamburg, Deutschland
  • Holger Reinecke - Universitätsklinikum Münster, Abteilung für Angiologie, Department für Kardiologie und Angiologie, Münster, Deutschland
  • Karl Wegscheider - Institut für Universitäts-klinikum Hamburg-Eppendorf, 3 Institut für Medizinische Informatik, Biometrie und Epidemiologie, Hamburg, Deutschland

15. Deutscher Kongress für Versorgungsforschung. Berlin, 05.-07.10.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocP011

doi: 10.3205/16dkvf161, urn:nbn:de:0183-16dkvf1617

Veröffentlicht: 28. September 2016

© 2016 Freisinger et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Background: Women have been reported to be at increased risk for adverse events and a more unfavorable outcome in case of experiencing an acute myocardial infarction (AMI). Effort has been made to improve decision making processes in terms of diagnostics and therapies, which have been discussed as possible reasons for these gender related disparities. However, the effectiveness of these measures taken to overcome the disadvantageous impact of the female gender on AMI outcome is a current matter of debate.

Aims: We sought to analyze the impact of gender on current trends and management in patients with AMI on a nationwide basis for Germany in a real-life scenario.

Methods: Data on all German hospitalized cases with AMI as the primary diagnosis in the year 2009 were transferred to the Federal Statistical Office (DESTATIS) and made available for further analysis. We evaluated these real-life data with regard to sex-based differences in risk constellation, AMI frequency, treatment, and in-hospital mortality.

Results: Females suffer less frequently from both, ST-elevation AMI (STEMI; 52,965 male vs. 25,146 female) and non-ST-elevation AMI (NSTEMI; 76,490 male vs. 48,505 female). The estimated overall in-hospital mortality of STEMI did not differ between males and females if they are younger than 70 years, but females at the age ≥80 years fare worse (p<0.05). In particular with increasing age, female gender was associated with a significantly lower chance for invasive diagnostics and therapy (p<0.001) although coronary angiography was associated with an equal reduction of the estimated in-hospital mortality in STEMI in both gender, with high age-groups even benefiting the most (see Figure 1 [Fig. 1]).

Discussion: Our data show particularly older women to be less invasively treated, although expecting equal benefit compared to men. However, this is not reflected in exceeding in-hospital mortality in females.

Practical implications:

Our analysis illustrates the actual nationwide healthcare situation of AMI patients in a real-life scenario with focus on gender aspects. Particularly older women receive less often invasive therapy despite expecting a significant benefit in reduction of in-hospital mortality. Therefore, our results point out the need for improved guideline adherent treatment in high age-groups particularly in women with AMI.