Key result
Young women with AMI face ~53% higher in-hospital mortality than men despite overall falling rates.
Why the study?
Young women (<60 years) experience higher in-hospital mortality following AMI compared to age-matched men, and the extent to which public health policies in Chile have reduced this disparity remains unclear.
Despite significant reductions in AMI in-hospital mortality in Chile over the last 20 years, a persistent gender gap remains, particularly affecting younger women.
Mortality fell more in women yet young women retain higher AMI risk; extends prior observations and leaves open targeted strategies.
Introduction Previous studies have demonstrated that young women (<60 years) experience higher in-hospital mortality following acute myocardial infarction (AMI) compared to men of the same age. In Chile, public policies such as Universal Health Coverage and educational campaigns have been implemented to improve AMI diagnosis and treatment, focusing on increasing disease awareness among women. However, the extent to which these measures have contributed to reducing this disparity remains unclear. Objective To analyze and compare trends in in-hospital mortality by sex and age in Chile between 2001 and 2023. Methods Annual in-hospital mortality rates were estimated, stratified by sex and age group (<39, 40-49, 50-59, 60-69, 70-79, 80-89, ≥90 years). The study included all AMI cases identified from hospital discharge records of National databases from the Ministry of Health (ICD-10 code: I21). Trends were evaluated using Prais-Winsten regression (PW coefficient, 95% CI). Relative risk (RR) for in-hospital mortality among women was estimated using Poisson regression (with men as the reference group) across three periods (2001-2008; 2009-2015; 2016-2023). An interaction model between sex and time period was applied to assess changes in RR over time. Results In-hospital mortality significantly declined between 2001 and 2023 in men (from 10% to 5%) and women (from 18% to 7%). Although PW regression indicated a more significant reduction in mortality among women (PW coefficient: -0.57 [95% CI: -0.72; -0.42]) compared to men (-0.30 [95% CI: -0.21; -0.38]), the gender gap persisted. In 2001, women had a 77% higher in-hospital mortality rate than men, which dropped to 53% in 2023 (Fig. A). The excess risk of in-hospital mortality was more pronounced among younger women (relative to men of the same age group). Still, this difference was no longer statistically significant in women aged ≥80 years (Fig. B). Conclusion Conclusion: women have experienced a more significant reduction in in-hospital mortality due to AMI versus men in the last 20 years. But, the gender gap persists, particularly in younger women. These findings underscore the need to address the heightened vulnerability of this population, considering social and contextual risk factors. .
No takes yet. Share an insight, caveat, or question.
Nazzal et al. (2025) studied this question. In Chile from 2001-2023, in-hospital AMI mortality fell from 18% to 7% in women and 10% to 5% in men, but young women remain at 53% higher risk than men in 2023.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: