Coronary Artery Disease in Men and Women

To the Editor: Vaccarino et al. (July 22 issue) 1 show that younger women, but not older women, have higher rates of death during hospitalization after acute myocardial infarction than men of the same age. Potential reasons for their findings include differences between men and women with respect to the aggressiveness of the disease, the treatment strategies used, and rates of death before hospitalization. Studies from the World Health Organization's Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) project have shown that a higher rate of death from acute myocardial infarction during hospitalization among women may be balanced by a higher . . .