Background Return to work (RTW) after an acute myocardial infarction (AMI) is an important outcome particularly relevant to young and active patients. Women may be at a greater risk for not returning to work given evidence of their worse recovery after AMI than similarly aged men. However, sex differences in return to work after AMI has not been studied extensively in a young active population (≤65 years). This study aimed to assess return to work among patients after an AMI and evaluate the role of gender.

Methods We prospectively followed patients with a first time AMI, employed at the time of the index hospitalization between June 2018 and December 2019, in the Cardiology department in a Public hospital in the central region of Tunisia. Data were obtained by medical record abstraction and patient interviews. Data collected were related to socio-demographic characteristics, clinical characteristics and the validated MacNew Questionnaire.

Results Fifty patients were enrolled aged 35 to 65 years. The study group was made up of 45 (90%) male and 5 (10%) female. Patients who did and did not return to work did not differ in gender distribution (p=0.79). Women returned to work later than men (respectively after 65 and 75 days) without statistically significant difference (p=0.87). Eighty four percent of the study population returned to work within six months. Smoking, left ventricular ejection, Killip class, in-hospital complications, global physical activity and Quality of Life were found to be significantly associated with return to work in independent univariate analyzes. A stepwise multivariate regression analysis identified only the Quality of Life and the number of children in charge as predictors of RTW.

Conclusion This study revealed a higher probability of RTW in males among a young active population. This difference is explained by disparities in demographic, occupational and health characteristics.