Mortality Following Myocardial Infarction in Women and Men: In Reply

by Priv.-Doz. Dr. med. Günther Heller, Dr. P. H. Birgit Babitsch, Dipl. Math. Christian Günster, Priv.-Doz. Dr. med. Martin Möckel in volume 15/2008

The conclusion in the first paragraph of the letter from Prof. Dören seems to match the statements and interpretations of our study and does not seem to require a reply. The second paragraph addresses the results of the MONICA (Augsburg) and KORA studies, especially the increase in myocardial infarctions in younger patients (25-54) from 1985/87-2001/03. No confidence intervals are given for the mentioned incidence rates in younger women in the cited study; no statistical test was conducted either. In view of the small number of cases in this sub-group it might almost be presumed that the described increase in the incidence of myocardial infarction in younger women does not reach significance. However, the rise in incidence rates in this cohort may be explained by "increased awareness among doctors" in this cohort—an assumption that is supported by only little empirical proof, as far as we're aware. In reverse, a clear increase in smoking—a crucial, behavior related risk factor that is bound to result in an increase in myocardial infarction—has been shown for younger women in Germany in several large population based studies.
DOI: 10.3238/arztebl.2008.763b


Priv.-Doz. Dr. med. Günther Heller, Dipl.-Math. Christian Günster
Wissenschaftliches Institut der AOK (WIdO)
Kortrijker Str. 1, 53177 Bonn, Germany
[e-mail], [e-mail]
Dr. Birgit Babitsch, MPH
Zentrum für Geschlechterforschung
Charité – Universitätsmedizin Berlin
Luisenstr. 65, 10117 Berlin, Germany
[e-mail]
Prof. Dr. med. Martin Möckel
Medizinische Klinik mit Schwerpunkt Kardiologie, Campus Virchow-Klinikum
Charité – Universitätsmedizin Berlin
Gemeinsame Einrichtung von Freier Universität Berlin
und Humboldt-Universität zu Berlin
Augustenburger Platz 1, 13353 Berlin, Germany
[e-mail]

Conflict of interest statement
The authors declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.

References

1. Löwel H: Koronare Herzkrankheit und akuter Myokardinfarkt. In: Robert-Koch-Institut, Statistisches Bundesamt (Hrsg). Gesundheitsberichterstattung des Bundes, Heft 33, 2006 .

2. Junge B, Nagel M: Das Rauchverhalten in Deutschland. Gesundheitswesen 1999; 61: 121–5.

3. Lampert T, Burger M: Rauchgewohnheiten in Deutschland – Ergebnisse des telefonischen Bundes-Gesundheitssurveys 2003. Gesundheitswesen 2004; 66: 511–7.