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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Age-Stratified Sex Disparities in Care and Outcomes in Patients With ST-Elevation Myocardial Infarction
American Journal of Medicine, Volume 133, No. 11, Year 2020
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Description
Background: Women are undertreated and have worse clinical outcomes than men after acute myocardial infarction. It remains uncertain whether the sex disparities in treatments and outcomes persist in the contemporary era and whether they affect all age groups equally. Methods: Using the National Inpatient Sample (NIS) registry, we evaluated 1,260,200 hospitalizations for ST-elevation myocardial infarction (STEMI) between 2010 and 2016, of which 32% were for women. The age-stratified sex differences in care measures and mortality were examined. Stepwise multivariable adjustment models, including baseline comorbidities, hospital characteristics, and reperfusion and revascularization therapies, were used to compare measures and outcomes between women and men across different age subgroups. Results: Overall, women with STEMI were older than men and had more comorbidities. Women were less likely to receive fibrinolytic therapy, percutaneous coronary intervention (PCI), and coronary artery bypass surgery across all age subgroups. Women with STEMI overall experienced higher unadjusted in-hospital mortality (11.1% vs 6.8%; adjusted odds ratio [OR] = 1.039, 95% confidence interval [CI]: 1.003-1.077), which persisted after multivariable adjustments. However, when stratified by age, the difference in mortality became non-significant in most age groups after stepwise multivariable adjustment, except among the youngest patients 19-49 years of age with STEMI (women vs men: 3.9% vs 2.6%; adjusted odds ratio = 1.259, 95% confidence interval: 1.083-1.464). Conclusions: Women with STEMI were less likely to receive reperfusion and revascularization therapies and had higher in-hospital mortality and complications compared with men. Younger women with STEMI (19-49 years of age) experienced higher in-hospital mortality that persisted after multivariable adjustment. © 2020
Authors & Co-Authors
Elbadawi, Ayman
United States, Galveston
The University of Texas Medical Branch at Galveston
Elgendy, Islam Y.
United States, Boston
Harvard Medical School
Megaly, Michael S.
United States, Minneapolis
Minneapolis Heart Institute
Ogunbayo, Gbolahan O.
United States, Lexington
University of Kentucky
Krittanawong, Chayakrit
United States, Houston
Baylor College of Medicine
Ballantyne, Christie Mitchell
United States, Houston
Baylor College of Medicine
Virani, Salim S.
United States, Houston
Michael E. Debakey va Medical Center
United States, Houston
Baylor College of Medicine
Gulati, Martha
United States, Tucson
The University of Arizona
Jneid, Hani M.
United States, Houston
Baylor College of Medicine
Statistics
Citations: 33
Authors: 9
Affiliations: 9
Identifiers
Doi:
10.1016/j.amjmed.2020.03.059
ISSN:
00029343
Research Areas
Health System And Policy
Study Design
Randomised Control Trial
Case-Control Study
Participants Gender
Male
Female