RT Journal
A1 Canto JG, Goldberg RJ, Kiefe CI
T1 SEx differences in presentation of myocardial infarction—reply
JF JAMA
JO JAMA
YR 2012
FD June 20
VO 307
IS 23
SP 2486
OP 2487
DO 10.1001/jama.2012.5287
UL http://dx.doi.org/10.1001/jama.2012.5287
AB 
In Reply: Successful outcomes research using registry data requires formulating clearly stated hypotheses prior to data analysis.1 We examined sex differences in MI symptom presentation (primary objective) and subsequent hospital mortality (secondary objective) after accounting for age among 1.1 million patients enrolled in the National Registry of Myocardial Infarction over the past decade. In our study, chest pain/discomfort was a common symptom of MI seen in more than two-thirds of the overall study population. However, the absence of chest pain/discomfort was more likely in women than in men (42.0% vs 30.7%, respectively). We demonstrated that younger women were more likely to present without chest pain/discomfort and had higher hospital mortality than similarly aged younger men (<55 years of age), but sex differences in presentation and mortality were markedly attenuated and nearly disappeared with increasing age.