In cases of acute myocardial infarction (AMI), female sex has been linked to a poor prognosis. Researchers looked at sex disparities in acute myocardial infarction (AMI) outcomes and recent developments in patient care in this countrywide study.
This study looked at morbidity, in-hospital mortality, and therapies for 8,75,735 German patients who were admitted to the hospital with a confirmed diagnosis of ST- (STEMI) or non-ST-elevation myocardial infarction (NSTEMI) between January 1, 2014, and December 31, 2017. The utilization of interventions and their impact on in-hospital mortality was assessed using a multivariable logistic regression model.
There was a reduction in STEMI cases from72,894 in 2014 to 68,213 in 2017, with men accounting for 70% of the cases. A higher prevalence of cardiovascular risk factors such as chronic renal disease (19.2% vs. 12.5%), hypertension (69% vs. 65%), and left ventricular heart failure (36% vs. 32.1%) was observed in the female sex. Female sex was also linked to an older age (78 vs. 71 years) and a higher prevalence of cardiovascular risk factors such as hypertension (77.4% vs. 74.5%), chronic renal disease (29.7% vs. 23.9%), and left ventricular heart failure (40.5% vs. 36.4%) in NSTEMI.
Percutaneous coronary intervention (PCI) was performed in 74.3% of female STEMI cases and 81.3% of male STEMI cases (p <0.001). PCI was conducted in 40.8% of female cases and 52% of male cases in NSTEMI (p 0.001). Compared to males, female patients with STEMI (15% vs. 9.6%; p <0.001; OR 1.07; 95% CI 1.03–1.010) and NSTEMI (8.3% vs. 6.3%; p <0.001; OR 0.91; 95% CI 0.89–0.93) had significantly higher in-hospital mortality.
In-patient STEMI cases continue to decline in both women and men, according to nationwide real-world data. In-hospital mortality was found to be greater in women due to a more unfavorable risk and age distribution. Women with AMI are still less likely than men to get revascularization treatments.