Sex differences in trends and outcomes of acute myocardial infarction with mechanical complications in the United States

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posted on 2024-01-31, 09:20 authored by Frederick Berro Rivera, Faye Salva, Jacques Simon Gonzales, Sung Whoy Cha, Samantha Tang, Grace Nooriza Opay Lumbang, Gurleen Kaur, Isabel Planek, Kyla Lara-Breitinger, Mark Dela Cruz, Tisha Marie B. Suboc, Fareed Moses S. Collado, Jonathan R. Enriquez, Nishant Shah, Annabelle Santos Volgman

Mechanical complications (MC) are rare but significant sequelae of acute myocardial infarction (AMI). Current data on sex differences in AMI with MC is limited.

We queried the National Inpatient Sample database to identify adult patients with the primary diagnosis of AMI and MC. The main outcome of interest was sex difference in-hospital mortality. Secondary outcomes were sex differences in the incidence of acute kidney injury (AKI), major bleeding, use of inotropes, permanent pacemaker implantation (PPMI), performance of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), surgery (VSD repair and MV surgery), pericardiocentesis, use of mechanical circulatory support (MCS), ischemic stroke, and mechanical ventilation.

Among AMI-MC cohort, in-hospital mortality was higher among females compared to males (41.24% vs 28.13%: aOR 1.39. 95% CI 1.079–1.798; p = 0.01). Among those who had VSD, females also had higher in-hospital mortality compared to males (56.7% vs 43.1%: aOR 1.74, 95% CI 1.12–2.69; p = 0.01). Females were less likely to receive CABG compared to males (12.03% vs 20%: aOR 0.49 95% CI 0.345–0.690; p < 0.001).

Despite the decreasing trend in AMI admission, females had higher risk of MC and associated mortality. Significant sex disparities still exist in AMI treatment.