José M de Miguel-Yanes1, Rodrigo Jiménez-García2, Valentin Hernandez-Barrera3, Javier de Miguel-Díez4, Nuria Muñoz-Rivas5, Manuel Méndez-Bailón6, Napoleón Pérez-Farinós7, Marta López-Herranz8, Ana Lopez-de-Andres2. 1. Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28040 Madrid, Spain. 2. Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain. 3. Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcon, 28922 Madrid, Spain. 4. Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28040 Madrid, Spain. 5. Internal Medicine Department, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain. 6. Internal Medicine Department, Hospital Universitario Clínico San Carlos, Universidad Complutense de Madrid, 28040 Madrid, Spain. 7. Public Health and Psychiatry Department, Faculty of Medicine, Universidad de Malaga, 29010 Malaga, Spain. 8. Nursing Department, Faculty of Nursing, Physiotherapy and Podology, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Abstract
(1) Background: Our aim was to analyze the incidence, procedures, and in-hospital outcomes of myocardial infarction (MI) in Spain (2016-2018) according to sex. (2) Methods: We estimated the incidence of an ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) according to sex using the Spanish National Hospital Discharge Database. A matched-pair analysis was used. (3) Results: MI was coded in 156,826 patients aged ≥18 years (111,842 men and 44,984 women). Men showed higher incidence rates (205.0 vs. 77.8 per 100,000; p < 0.001; IRR = 2.81(95%CI:2.78-2.84)). After matching, the use of coronary artery by-pass grafting (CABG) (1.0% vs. 0.7%; p < 0.001) and percutaneous coronary intervention (PCI) (57.8% vs. 52.3%; p < 0.001) was higher among men with an STEMI, whereas the in-hospital mortality (IHM) remained higher among women (11.2% vs. 10.1%; p < 0.001). Likewise, CABG (1.9% vs. 3.3%; p < 0.001) and PCI (33.8% vs. 41.9%; p < 0.001) were less often used among women with an NSTEMI, but no sex-related differences were found in IHM. After adjusting for confounders, IHM was more than twofold higher for both men and women with an STEMI than those with an NSTEMI. Women with an STEMI had a 21% higher mortality risk than men (OR = 1.21(95%CI:1.13-1.29). (4) Conclusion: Men had higher incidence rates of MI than women. Women underwent invasive procedures less often and had a higher IHM when admitted for an STEMI.
(1) Background: Our aim was to analyze the incidence, procedures, and in-hospital outcomes of myocardial infarction (MI) in Spain (2016-2018) according to sex. (2) Methods: We estimated the incidence of an ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) according to sex using the Spanish National Hospital Discharge Database. A matched-pair analysis was used. (3) Results: MI was coded in 156,826 patients aged ≥18 years (111,842 men and 44,984 women). Men showed higher incidence rates (205.0 vs. 77.8 per 100,000; p < 0.001; IRR = 2.81(95%CI:2.78-2.84)). After matching, the use of coronary artery by-pass grafting (CABG) (1.0% vs. 0.7%; p < 0.001) and percutaneous coronary intervention (PCI) (57.8% vs. 52.3%; p < 0.001) was higher among men with an STEMI, whereas the in-hospital mortality (IHM) remained higher among women (11.2% vs. 10.1%; p < 0.001). Likewise, CABG (1.9% vs. 3.3%; p < 0.001) and PCI (33.8% vs. 41.9%; p < 0.001) were less often used among women with an NSTEMI, but no sex-related differences were found in IHM. After adjusting for confounders, IHM was more than twofold higher for both men and women with an STEMI than those with an NSTEMI. Women with an STEMI had a 21% higher mortality risk than men (OR = 1.21(95%CI:1.13-1.29). (4) Conclusion:Men had higher incidence rates of MI than women. Women underwent invasive procedures less often and had a higher IHM when admitted for an STEMI.
Entities:
Keywords:
NSTEMI; STEMI; gender; in-hospital mortality; myocardial infarction; sex differences
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