Sex and outcome after myocardial infarction: A case of sexual politics?
The concluding decades of the last millennium have brought about a dramatic transformation in the role of women in Western society. Along with a growth in equality in the social and political landscape, there has been an increased awareness of the manifestations of diseases and their diagnosis, management, and outcome in women.

The treatment of women with coronary disease has received particularly intense scrutiny. A multitude of studies have been published from administrative databases, patient registries, clinical trials, and population-based surveys. These have evaluated findings in women with diagnoses of chest pain, stable coronary disease, ST elevation myocardial infarction (MI), and non-ST elevation acute ischemic syndromes. Although the anatomic biological differences are incompletely understood,1 the following 3 key questions have been posed: (1) does the outcome of women with coronary artery disease differ from that of men? (2) Do treatment and management strategies differ between the sexes? (3) Is the effect of treatment and outcome similar for both sexes? The findings in studies have been inconsistent, but nonetheless, several areas of agreement and consensus exist (Table⇓).

The report by Gottlieb et al2 advances our understanding of the relationship between treatment and outcome in the setting of acute MI. This study was derived from a comprehensive national registry of all coronary care units in Israel, and it reports data on hospitalized patients with a diagnosis of acute MI over 2 months during 3 different years. A particular …