Women with AMI had higher GRACE scores, more hypertension, hypothyroidism, sedentary lifestyle, longer door-to-balloon delays (OR 2.8), and more MINOCA (OR 1.8) than men.
Do clinical characteristics, care delays, and angiographic findings differ between female and male patients presenting with acute myocardial infarction?
Women presenting with acute myocardial infarction have higher baseline risk scores, experience greater delays in door-to-balloon times, and are more likely to have MINOCA compared to men.
Absolute Event Rate: 0% vs 0%
Abstract Background Women often face poorer outcomes after myocardial infarction (MI) compared to men. Recent studies reveal sex-based differences in acute myocardial infarction (AMI), including clinical characteristics, treatment strategies, and prognostic implications. Methods An observational, analytical, retrospective cohort study was conducted involving patients with acute myocardial infarction (AMI) from November 2019 to June 2023. A univariate and bivariate analysis was performed, comparing the risk factors, coronary disease characteristics, and outcomes across sex groups. The main objective of this study was to evaluate differences in care in female patients and angiographic findings. Results From November 1, 2019, to June 30, 2023, a total of 455 patients with AMI were registered. Of these patients, 107 (23%) were women. Male patients with AMI were more likely to have a ST-elevation Myocardial Infarction (STEMI), with an odds ratio (OR) of 1.58 (95% CI: 1.01–2.48). Female patients with AMI did not show significant differences in the prevalence of diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation, coronary artery disease, dyslipidemia, cancer, obstructive sleep apnea syndrome (OSAS), chronic kidney disease (CKD), dialysis, or depression compared to male patients. Among male patients there was a higher prevalence of alcohol consumption and smoking history with ORs of 4.03 (95% CI: 1.80–9.03), and 2.23 (95% CI: 1.37–3.61), respectively. In contrast, female patients have higher prevalence of prior medical history of arterial hypertension, hypothyroidism and sedentary lifestyle with ORs of 1.93 (95% CI: 1.21–3.08), 2.90 (95% CI: 1.75–4.79) and 1.69 (95% CI: 1.07–2.65), respectively. Male patients had higher average weights (77 kg vs. 63 kg), which was statistically significant with a p-value of less than 0.01. But female patients had a higher GRACE score than male patients (125 vs. 110, p 0.01). The average door-to-balloon time for STEMI shows delays were more likely to occur in female population, for every man who failed to meet the door-to-balloon time target of 90 minutes, there were three women who do not achieve this goal, OR 2,8 (95% CI:1.19-6.70). Angiographic findings showed that thrombus formation was more prevalent in male patients, OR 3.3 (95% CI: 1.61–6.49). In contrast, myocardial infarction with non-obstructive coronary arteries (MINOCA) was 1.8 times more common in female patients. Conclusion This study reveals gender differences in acute myocardial infarction (AMI) presentation and outcomes. Women exhibit more risk factors, including hypertension, hypothyroidism, and sedentary behavior. Women also face delays in door-to-balloon time and are more likely to have myocardial infarction with non-obstructive coronary arteries. These findings underscore the need for gender-specific strategies in AMI care and prevention.Females and male differences
Ramirez et al. (Sat,) reported a other. Women with AMI had higher GRACE scores, more hypertension, hypothyroidism, sedentary lifestyle, longer door-to-balloon delays (OR 2.8), and more MINOCA (OR 1.8) than men.
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