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Does Diabetes Mellitus Explain the Higher Hospital Mortality of Women with Acute Myocardial Infarction? Results from the Berlin Myocardial Infarction Registry
  1. Birga Maier,
  2. Walter Thimme,
  3. Gerd Kallischnigg,
  4. Claudia Graf-Bothe,
  5. Jens-Uwe Röhnisch,
  6. Claire Hegenbarth,
  7. Heinz Theres
  1. 1From the Interdisciplinary Network for Epidemiological Research in Berlin (B.M.), Technische Universitaet, Berlin, Germany; Berlin Myocardial Infarction Registry (B.M., W.T., G.K.), Berlin, Germany; Institute for Health Sciences (G.K.), Technische Universitaet, Berlin, Germany; DRK Kliniken Westend (C.G.-B.), Berlin, Germany; Vivantes Klinikum Hellersdorf (J.-U.R.), Berlin, Germany; Vivantes Humboldt Klinikum (C.H.), Berlin, Germany; and Universitätsklinikum Charité Campus Mitte (H.T.), Berlin, Germany
  1. Address correspondence to: Dr. Birga Maier, Interdisciplinary Network for Epidemiological Research in Berlin (EpiBerlin), Technische Universitaet Berlin, Ernst-Reuter-Platz 7, TEL 10-7, D-10587 Berlin, Germany; e-mail: birga.maier{at}
  2. *Hospitals in Berlin covered by this study: Bundeswehrkrankenhaus Berlin: Bubser H P; Caritas-Kliniken Pankow Bereich Maria Heimsuchung: Beckert J; Charité Universitätsmedizin Berlin, Campus Berlin Mitte: Baumann G; Charité Universitätsmedizin Berlin, Campus Buch, Franz Volhard-Klinik: Dietz R; Dominikus Krankenhaus GmbH: Wiek K; DRKKliniken Berlin Westend: Schoeller R; DRK-Kliniken Mark Brandenburg: Dorow P; Elisabeth Diakonissen-Krankenhaus: Waetke M; Ev. Waldkrankenhaus Spandau: Aulbert E; Gemeinschaftskrankenhaus Havelhöhe: Fried A; Jü disches Krankenhaus: Bethge C; Krankenhaus Hedwigshöhe: Metze G; Krankenhaus Lichtenberg: Göing O; Martin Luther Krankenhaus: Oltmanns D; Park-Klinik Weissensee: Goldstein M; St. Gertrauden-Krankenhaus: Ramdohr B; St. Marien-Krankenhaus Lankwitz: Gross-Albenhausen B; Unfallkrankenhaus Berlin: Kleber F X; Vivantes Auguste-Viktoria-Klinikum (former also Krankenhaus Moabit): Schüren K P; Vivantes Humboldt Klinikum: Behrens S; Vivantes Klinikum am Urban: Andresen D; Vivantes Klinikum Hellersdorf: Titlbach O-J; Vivantes Klinikum im Friedrichshain: Andresen D; Vivantes Wenckebach Klinikum: Henzgen R.


Background Women with acute myocardial infarction (AMI) exhibit greater hospital mortality than do men. In general, diabetes mellitus is one of the major factors influencing the outcome of patients with AMI. The aim of this study was to analyze the interaction between diabetes and gender, specifically with regard to the higher hospital mortality of female AMI patients aged ≤ 75 years.

Methods We prospectively collected data from 3,715 patients aged ≤ 75 (2,794 men, 921 women) with acute myocardial infarction who were treated in 25 hospitals in Berlin, Germany, from 1999 to 2002. In a multivariate analysis, we specifically studied the interaction between the factors diabetes mellitus and gender in their effects on hospital mortality.

Results After adjustment in multivariate analysis, the interaction between gender and diabetes was statistically significant, and the estimated odds ratios were as follows: female diabetic patients compared with male diabetic patients, odds ratio (OR) = 2.28 (95% confidence interval [CI] 1.42-3.68); female diabetic patients compared with male nondiabetic patients, OR = 2.90 (95% CI 1.90-4.42); and female diabetic patients compared with female nondiabetic patients, OR = 2.92 (95% CI 1.75-4.87). There was no statistically significant difference between the risk of dying for female nondiabetic patients or for male diabetic patients when compared with male nondiabetic patients.

Conclusions In AMI patients aged ≤ 75 years, female gender alone is not an independent predictor of hospital mortality. Detailed, multivariate analysis reveals that specifically diabetic women demonstrate higher hospital mortality than do men. Special attention should be provided to these female diabetic patients.

Key Words
  • acute myocardial infarction
  • diabetes
  • gender
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