Goldsmith, a successful management consultant before she took up writing, died Thursday at Lenox Hill Hospital, said her lawyer, Steven Mintz.
"The First Wives Club," which came out in 1992, spun a tale of three women who band together to seek revenge after their wealthy, successful husbands leave them for younger partners.
The book sold millions of copies and it became a No. 1 film in 1996 starring Goldie Hawn, Diane Keaton and Bette Midler. Hawn's character is a plastic surgery fan who in one scene pleads with her doctor for yet another procedure.
"I wrote `First Wives Club' in true indignation," Goldsmith told The Associated Press in a 1996 interview.
"It's not right. You choose a woman who bears your young and then you discard her for a younger, taller, thinner, blonder model."
"We are expected to have jobs now," she said. "We are expected to raise the family. We're responsible for the home, and we have to have thin thighs. Nobody can do it."
Among her other novels were "The Bestseller," "Flavor of the Month," "Young Wives," and "Switcheroo." A new novel, "Dumping Billy," is scheduled for a spring release. She had also just finished editing "Casting On," said her agent, Nicholas Ellison.
Ellison said Goldsmith had been in a coma since she suffered a heart attack Jan. 7 as she went under anesthesia for a procedure to remove loose skin from her chin.
While in the business world, Goldsmith became one of the first women to become a partner at the firm Booz Allen Hamilton. She decided to turn to writing after leaving New York for three years in London, Ellison said.
"It was a calling," he said. "She thought it would be a richer, more satisfying life."
In interviews, Goldsmith acknowledged having undergone a painful divorce, but Ellison said she did not write "The First Wives Club" from her own experience.
"In no way was it a mirror of her marriage or autobiographical at all," Ellison said. "It was just drawn from life, as satirists do."
Goldsmith was born Randy Goldfield in New York City. She changed her legal name to Justine Rendal and wrote under the pen name of Olivia Goldsmith.
She is survived by her mother and two sisters.