Trends of Sex Differences in Clinical Outcomes After Myocardial Infarction in the United States

作者：Andrija Matetić, Warkaa Shamkhani, Muhammad Rashid, Annabelle Santos Volgman, Harriette G.C. Van Spall, Thais Coutinho, Laxmi S. Mehta, Garima Sharma, Purvi Parwani, Mohamed O. Mohamed, Mamas A. Mamas · 发表于：CJC Open · 年份：2021 · DOI：10.1016/j.cjco.2021.06.012 · 被引用次数：46 · 研究领域：Acute Myocardial Infarction Research、Sex and Gender in Healthcare、Cardiac Health and Mental Health

Background Female patients have been shown to experience worse clinical outcomes after acute myocardial infarction (AMI) compared with male patients. However, it is unclear what trend these differences followed over time. Methods Data from patients hospitalized with AMI between 2004 and 2015 in the National Inpatient Sample were retrospectively analyzed, stratified according to sex. Multivariable logistic regression analyses were performed to examine the adjusted odds ratios (aORs) of invasive management and in-hospital outcomes according to sex. The Mantel-Haenszel extension of the χ 2 test was performed to examine the trend of management and in-hospital outcomes over the study period. Results Of 7,026,432 AMI hospitalizations, 39.7% (n = 2,789,494) were women. Overall, women were older (median: 77 vs 70 years), with a higher prevalence of risk factors such as diabetes, hypertension, and depression. Women were less likely to receive coronary angiography (aOR, 0.92; 95% confidence interval [CI], 0.91-0.93) and percutaneous coronary intervention (aOR, 0.82; 95% CI, 0.81-0.83) compared with men. Odds of all-cause mortality were higher in women (aOR, 1.03; 95% CI, 1.02-1.04; P < 0.001) and these rates have not narrowed over time (2004 vs 2015: aOR, 1.07 [95% CI, 1.04-1.09] vs 1.11 [95% CI, 1.07-1.15), with similar observations recorded for major adverse cardiovascular and cerebrovascular events. Conclusions In this temporal analysis of AMI hospitalizations over 12 years, we show...