Dhrubajyoti Bandyopadhyay1, Sandipan Chakraborty2, Birendra Amgai2, Neelkumar Patel2, Adrija Hajra3, Lyndsey Heise4, Karan Sud5, Raktim K Ghosh6, Eyal Herzog7, Wilbert S Aronow8, Gregg C Fonarow9, Carl J Lavie10. 1. Icahn School of Medicine at Mount Sinai, Mount Sinai St Luke's Roosevelt Hospital, Manhattan, NY, United States of America. Electronic address: dhrubajyoti.bandyopadhyay@mountsinai.org. 2. Interfaith Medical Center, Brooklyn, NY, United States of America. 3. Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States of America. 4. Northwestern Medicine, Chicago, IL, United States of America. 5. Icahn School of Medicine at Mount Sinai, Mount Sinai St Luke's Roosevelt Hospital, Manhattan, NY, United States of America. 6. Case Western Reserve University, Heart and Vascular Institute, MetroHealth Medical Center, Cleveland, OH, United States of America. 7. Icahn School of Medicine at Mount Sinai, Mount Sinai St Luke's Roosevelt Hospital, Manhattan, NY, United States of America. Electronic address: Eyal.herzog@mountsinai.org. 8. New York Medical College, New York, United States of America. Electronic address: Wilbert.Aronow@wmchealth.org. 9. Ronald Reagan-UCLA Medical Center, Los Angeles, Los Angeles, CA, United States of America. Electronic address: GFonarow@mednet.ucla.edu. 10. John Ochsner Heart and Vascular Institute, Ochsner Clinical School, the University of Queensland School of Medicine, New Orleans, LA, United States of America. Electronic address: clavie@ochsner.org.
Abstract
INTRODUCTION: Although acute myocardial infarction (AMI) is a disease predominantly affecting adults >60 years of age, a significant proportion of the young population who have different risk profiles, are also affected. We undertook a retrospective analysis using National Inpatient Sample (NIS) 2010 to 2014 to evaluate gender differences in characteristics, treatments, and outcomes in the younger AMI population. METHODS: The NIS 2010-2014 was used to identify all patient hospitalizations with AMI between 18 to <45 years using ICD-9-CM codes. We demonstrated a gender-based difference of in-hospital all-cause mortality, other complications, and revascularization strategies in the overall AMI population and other subgroups of AMI [anterior wall ST-segment elevation MI (STEMI), and non-anterior wall STEMI and non-STEMI (NSTEMI)]. RESULTS: A total of 156,018 weighted records of AMI hospitalizations were identified, of which 111,894 were men and 44,124 were women. Young women had a higher prevalence of anemia, chronic lung disease, obesity, peripheral vascular disease, and diabetes. Conversely, young men had a higher prevalence of dyslipidemia, smoking, and alcohol. Among non-traditional risk factors, women had a higher prevalence of depression and rheumatologic/collagen vascular disease. There was no difference in all-cause in-hospital mortality in women compared to men [2.03% vs 1.48%; OR 1.04, CI (0.84-1.29); P = .68], including in subgroup analysis of NSTEMI, anterior wall STEMI, and non-anterior wall STEMI. Women with AMI were less likely to undergo percutaneous coronary intervention [47.13% vs 61.17%; OR 0.66, 95% CI (0.62-0.70; P < .001] and coronary artery bypass grafting [5.6% vs 6.0%; OR 0.73, 95% CI 0.64-0.83; P < .001] compared to men. Women were also less likely to undergo percutaneous coronary intervention within 24 h of presentation (38.47% vs 51.42%, P < .001). CONCLUSION: Despite higher baseline comorbidities in young women with AMI, there was no difference in in-hospital mortality in women compared to men. Additional studies are needed to evaluate the impact of gender on clinical presentation, treatment patterns, and outcomes of AMI in young patients.
INTRODUCTION: Although acute myocardial infarction (AMI) is a disease predominantly affecting adults >60 years of age, a significant proportion of the young population who have different risk profiles, are also affected. We undertook a retrospective analysis using National Inpatient Sample (NIS) 2010 to 2014 to evaluate gender differences in characteristics, treatments, and outcomes in the younger AMI population. METHODS: The NIS 2010-2014 was used to identify all patient hospitalizations with AMI between 18 to <45 years using ICD-9-CM codes. We demonstrated a gender-based difference of in-hospital all-cause mortality, other complications, and revascularization strategies in the overall AMI population and other subgroups of AMI [anterior wall ST-segment elevation MI (STEMI), and non-anterior wall STEMI and non-STEMI (NSTEMI)]. RESULTS: A total of 156,018 weighted records of AMI hospitalizations were identified, of which 111,894 were men and 44,124 were women. Young women had a higher prevalence of anemia, chronic lung disease, obesity, peripheral vascular disease, and diabetes. Conversely, young men had a higher prevalence of dyslipidemia, smoking, and alcohol. Among non-traditional risk factors, women had a higher prevalence of depression and rheumatologic/collagen vascular disease. There was no difference in all-cause in-hospital mortality in women compared to men [2.03% vs 1.48%; OR 1.04, CI (0.84-1.29); P = .68], including in subgroup analysis of NSTEMI, anterior wall STEMI, and non-anterior wall STEMI. Women with AMI were less likely to undergo percutaneous coronary intervention [47.13% vs 61.17%; OR 0.66, 95% CI (0.62-0.70; P < .001] and coronary artery bypass grafting [5.6% vs 6.0%; OR 0.73, 95% CI 0.64-0.83; P < .001] compared to men. Women were also less likely to undergo percutaneous coronary intervention within 24 h of presentation (38.47% vs 51.42%, P < .001). CONCLUSION: Despite higher baseline comorbidities in young women with AMI, there was no difference in in-hospital mortality in women compared to men. Additional studies are needed to evaluate the impact of gender on clinical presentation, treatment patterns, and outcomes of AMI in young patients.
Authors: Saraschandra Vallabhajosyula; Lina Ya'Qoub; Mandeep Singh; Malcolm R Bell; Rajiv Gulati; Wisit Cheungpasitporn; Pranathi R Sundaragiri; Virginia M Miller; Allan S Jaffe; Bernard J Gersh; David R Holmes; Gregory W Barsness Journal: Circ Heart Fail Date: 2020-09-29 Impact factor: 8.790