Age-Stratified Sex Disparities in Care and Outcomes in Patients with ST-elevation Myocardial Infarction – DocWire News

BACKGROUND:

Women are undertreated and have worse clinical outcomes than men after acutemyocardial 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.

Using the National Inpatient Sample registry, we evaluated 1,260,200 hospitalizations for ST-elevationmyocardial infarctionbetween 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 utilized to compare measures and outcomes between women and men across different age subgroups.

Overall, women with ST-elevationmyocardial infarctionwere older than men and had more comorbidities. Women were less likely to receive fibrinolytic therapy, percutaneous coronary intervention, and coronary artery bypass surgery across all age subgroups. Women with ST-elevationmyocardial infarctionoverall experienced higher unadjusted in-hospital mortality (11.1% vs 6.8%; adjusted OR=1.039, 95% 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 ST-elevationmyocardial infarctionpatients 19-49 years of age (women vs. men: 3.9% vs. 2.6%; adjusted OR=1.259, 95% CI:1.083-1.464).

Women with ST-elevationmyocardial infarctionwere less likely to receive reperfusion and revascularization therapies and had higher in-hospital mortality and complications compared to men. Younger women with ST-elevationmyocardial infarction(19-49 year of age) experienced higher in-hospital mortality that persisted after multivariable adjustment.

The rest is here:
Age-Stratified Sex Disparities in Care and Outcomes in Patients with ST-elevation Myocardial Infarction - DocWire News