Objective: To detect possible differences between men and women in thrombolytic treatment after acute myocardial infarction.
Design: Retrospective chart study.
Setting: University Hospital Nijmegen, the Netherlands.
Method: The data were studied of all patients diagnosed at discharge as 'myocardial infarction' during the period July 1992 to December 1993, with comparison of men and women.
Results: There were 181 patients with myocardial infarction: 53 women (29%) and 128 men (71%). At the time of diagnosis, the women on average were 9 years older than the men. Of these patients, 24 women (45%) and 66 men (52%) were treated with a thrombolytic agent. In 30% of the cases in both men and women, the main reason not to give a thrombolytic agent was exceeding the time limit of 6 hours after the first symptoms. In addition, thrombolysis was refrained from because of contraindications in 23% of the women and in 17% of the men. In women, an 'inconclusive' ECG was an important reason for not giving thrombolysis. There was a difference between the numbers of women and men who developed complications after thrombolysis (25% as against 8%); in women these complications were mostly haemorrhages. 25% of the women and 15% of the men died in hospital.
Conclusion: Women with a myocardial infarction were given thrombolytic treatment about as often as men. There were sex differences regarding the contraindications to thrombolysis and the complications after thrombolysis.