BACKGROUND: Older women presenting with ST-segment elevation myocardial infarction (STEMI) are less likely to receive revascularization and have worse outcomes relative to their male counterparts. OBJECTIVES: This study sought to determine temporal trends and sex differences in revascularization and in-hospital outcomes of younger patients with STEMI. METHODS: We used the 2004 to 2011 Nationwide Inpatient Sample databases to identify all patients age 18 to 59 years hospitalized with STEMI. Temporal trends and sex differences in revascularization strategies, in-hospital mortality, and length of stay were analyzed. RESULTS: From 2004 to 2011, of 1,363,492 younger adults (age <60 years) with acute myocardial infarction, 632,930 (46.4%) had STEMI. Younger women with acute myocardial infarction were less likely than men to present with STEMI (adjusted odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.73 to 0.75). Younger women with STEMI were less likely to receive reperfusion as compared with younger men (percutaneous coronary intervention adjusted OR: 0.74; 95% CI: 0.73 to 0.75) (coronary artery bypass grafting adjusted OR: 0.61; 95% CI: 0.60 to 0.62) (thrombolysis adjusted OR: 0.80; 95% CI: 0.78 to 0.82). From 2004 to 2011, use of percutaneous coronary intervention for STEMI increased in both younger men (63.9% to 84.8%; ptrend < 0.001) and women (53.6% to 77.7%; ptrend < 0.001). In-hospital mortality was significantly higher in younger women compared with men (4.5% vs. 3.0%; adjusted OR: 1.11; 95% CI: 1.07 to 1.15). There was an increasing trend in risk-adjusted in-hospital mortality in both younger men and women during the study period. Length of stay decreased in both younger men and women (ptrend < 0.001). CONCLUSIONS: Younger women are less likely to receive revascularization for STEMI and have higher in-hospital mortality as compared with younger men. Use of percutaneous coronary intervention for STEMI and in-hospital mortality have increased, whereas length of stay has decreased in both sexes over the past several years.
BACKGROUND: Older women presenting with ST-segment elevation myocardial infarction (STEMI) are less likely to receive revascularization and have worse outcomes relative to their male counterparts. OBJECTIVES: This study sought to determine temporal trends and sex differences in revascularization and in-hospital outcomes of younger patients with STEMI. METHODS: We used the 2004 to 2011 Nationwide Inpatient Sample databases to identify all patients age 18 to 59 years hospitalized with STEMI. Temporal trends and sex differences in revascularization strategies, in-hospital mortality, and length of stay were analyzed. RESULTS: From 2004 to 2011, of 1,363,492 younger adults (age <60 years) with acute myocardial infarction, 632,930 (46.4%) had STEMI. Younger women with acute myocardial infarction were less likely than men to present with STEMI (adjusted odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.73 to 0.75). Younger women with STEMI were less likely to receive reperfusion as compared with younger men (percutaneous coronary intervention adjusted OR: 0.74; 95% CI: 0.73 to 0.75) (coronary artery bypass grafting adjusted OR: 0.61; 95% CI: 0.60 to 0.62) (thrombolysis adjusted OR: 0.80; 95% CI: 0.78 to 0.82). From 2004 to 2011, use of percutaneous coronary intervention for STEMI increased in both younger men (63.9% to 84.8%; ptrend < 0.001) and women (53.6% to 77.7%; ptrend < 0.001). In-hospital mortality was significantly higher in younger women compared with men (4.5% vs. 3.0%; adjusted OR: 1.11; 95% CI: 1.07 to 1.15). There was an increasing trend in risk-adjusted in-hospital mortality in both younger men and women during the study period. Length of stay decreased in both younger men and women (ptrend < 0.001). CONCLUSIONS: Younger women are less likely to receive revascularization for STEMI and have higher in-hospital mortality as compared with younger men. Use of percutaneous coronary intervention for STEMI and in-hospital mortality have increased, whereas length of stay has decreased in both sexes over the past several years.
Authors: Alejandro Lemor; Alvaro J Ramos-Rodriguez; Ricardo De La Villa; Seyed H Hosseini Dehkordi; Fernando Vazquez de Lara; Shawn Lee; Mario Rodriguez Rivera; Abel Casso Dominguez; Edgar Argulian Journal: Clin Cardiol Date: 2018-11-26 Impact factor: 2.882
Authors: Jim W Cheung; Edward P Cheng; Xian Wu; Ilhwan Yeo; Paul J Christos; Hooman Kamel; Steven M Markowitz; Christopher F Liu; George Thomas; James E Ip; Bruce B Lerman; Luke K Kim Journal: Eur Heart J Date: 2019-09-21 Impact factor: 29.983
Authors: Aiham Albaeni; Khaled Chatila; Hind A Beydoun; May A Beydoun; Mohammad Morsy; Wissam I Khalife Journal: Int J Cardiol Date: 2019-07-23 Impact factor: 4.164
Authors: Ersilia M DeFilippis; Bradley L Collins; Avinainder Singh; David W Biery; Amber Fatima; Arman Qamar; Adam N Berman; Ankur Gupta; Mary Cawley; Malissa J Wood; Josh Klein; Jon Hainer; Martha Gulati; Viviany R Taqueti; Marcelo F Di Carli; Khurram Nasir; Deepak L Bhatt; Ron Blankstein Journal: Eur Heart J Date: 2020-11-07 Impact factor: 29.983
Authors: Janet Wei; Puja K Mehta; Elizabeth Grey; Ross F Garberich; Robert Hauser; C Noel Bairey Merz; Timothy D Henry Journal: Am Heart J Date: 2017-06-17 Impact factor: 4.749