Cardiovascular disease is the leading cause of mortality in American women. Since 1984, the annual cardiovascular disease mortality rate has remained greater for women than men; however, over the last decade, there have been marked reductions in cardiovascular disease mortality in women. The dramatic decline in mortality rates for women is attributed partly to an increase in awareness, a greater focus on women and cardiovascular disease risk, and the increased application of evidence-based treatments for established coronary heart disease. This is the first scientific statement from the American Heart Association on acute myocardial infarction in women. Sex-specific differences exist in the presentation, pathophysiological mechanisms, and outcomes in patients with acute myocardial infarction. This statement provides a comprehensive review of the current evidence of the clinical presentation, pathophysiology, treatment, and outcomes of women with acute myocardial infarction.

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In October 1983, a retrospective survey was initiated to determine if patients reported to the Centers for Disease Control as having recurrent tuberculosis truly had recurrent disease and, if so, why they had developed tuberculosis again. Twenty-three health jurisdictions provided information on 800 patients diagnosed as having recurrent tuberculosis during 1981 and 1982. We found that 199 (25 per cent) of the cases did not meet the criteria for recurrent disease. Of the remaining 601 recurrent cases, 20 per cent had no chemotherapy prescribed for their previous episodes of tuberculosis, 20 per cent were prescribed inadequate or inappropriate therapy, and 33 per cent were not compliant with their prescribed therapy regimens. Patients who, during their original episode of tuberculosis, received the major portion of their medical care from physicians in private practice were more compliant than those treated by other health care providers. However, those same patients were more likely to have received inappropriate therapy than patients treated by other providers. Better patient and physician education, closer monitoring, and greater use of preventive therapy and directly observed therapy are necessary to resolve these problems.

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