Key result
Female sex was associated with a significantly stronger impact of comorbidities such as nicotine dependence, diabetes mellitus, and obesity on the risk of acute myocardial infarction and chronic ischemic heart disease compared to male sex.
Why the study?
Although men are more prone to cardiovascular disease, certain risk factors are more detrimental in women, warranting systematic investigation of sex-specific comorbidity associations.
Does female sex modify the association between cardiovascular comorbidities and the risk of acute myocardial infarction or chronic ischemic heart disease compared to male sex?
Observational (n=2,716,967)
Does female sex modify the association between cardiovascular comorbidities and the risk of acute myocardial infarction or chronic ischemic heart disease compared to male sex?
Women experience a disproportionately higher risk of acute myocardial infarction and chronic ischemic heart disease from common comorbidities like smoking, diabetes, and obesity compared to men.
Answers are grounded in this paper and cite their sources.
Supports sex-specific comorbidity effects on ischemic risk; hypothesis-generating and should not yet change practice.
BACKGROUND: Although men are more prone to developing cardiovascular disease (CVD) than women, risk factors for CVD, such as nicotine abuse and diabetes mellitus, have been shown to be more detrimental in women than in men. OBJECTIVE: We developed a method to systematically investigate population-wide electronic health records for all possible associations between risk factors for CVD and other diagnoses. The developed structured approach allows an exploratory and comprehensive screening of all possible comorbidities of CVD, which are more connected to CVD in either men or women. METHODS: Based on a population-wide medical claims dataset comprising 44 million records of inpatient stays in Austria from 2003 to 2014, we determined comorbidities of acute myocardial infarction (AMI; International Classification of Diseases, Tenth Revision [ICD-10] code I21) and chronic ischemic heart disease (CHD; ICD-10 code I25) with a significantly different prevalence in men and women. We introduced a measure of sex difference as a measure of differences in logarithmic odds ratios (ORs) between male and female patients in units of pooled standard errors. RESULTS: Except for lipid metabolism disorders (OR for females [ORf]=6.68, 95% confidence interval [CI]=6.57-6.79, OR for males [ORm]=8.31, 95% CI=8.21-8.41), all identified comorbidities were more likely to be associated with AMI and CHD in females than in males: nicotine dependence (ORf=6.16, 95% CI=5.96-6.36, ORm=4.43, 95% CI=4.35-4.5), diabetes mellitus (ORf=3.52, 95% CI=3.45-3.59, ORm=3.13, 95% CI=3.07-3.19), obesity (ORf=3.64, 95% CI=3.56-3.72, ORm=3.33, 95% CI=3.27-3.39), renal disorders (ORf=4.27, 95% CI=4.11-4.44, ORm=3.74, 95% CI=3.67-3.81), asthma (ORf=2.09, 95% CI=1.96-2.23, ORm=1.59, 95% CI=1.5-1.68), and COPD (ORf=2.09, 95% CI 1.96-2.23, ORm=1.59, 95% CI 1.5-1.68). Similar results could be observed for AMI. CONCLUSIONS: Although AMI and CHD are more prevalent in men, women appear to be more affected by certain comorbidities of AMI and CHD in their risk for developing CVD.
No takes yet. Share an insight, caveat, or question.
Dervić et al. (2021) conducted an observational in Acute myocardial infarction and chronic ischemic heart disease (n=2,716,967). Female sex (with cardiovascular comorbidities) vs. Male sex was evaluated on Association of nicotine dependence with chronic ischemic heart disease in females compared to males (OR 6.16, 95% CI 5.96-6.36, p=<0.0001). Female sex was associated with a significantly stronger impact of comorbidities such as nicotine dependence, diabetes mellitus, and obesity on the risk of acute myocardial infarction and chronic ischemic heart disease compared to male sex.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: