Nationwide Routine-Data Analysis of Sex Differences in Outcome of Acute Myocardial Infarction
Standard
Nationwide Routine-Data Analysis of Sex Differences in Outcome of Acute Myocardial Infarction. / Freisinger, Eva; Sehner, Susanne; Malyar, Nasser M; Suling, Anna; Reinecke, Holger; Wegscheider, Karl.
In: CLIN CARDIOL, Vol. 41, No. 8, 08.2018, p. 1013-1021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Nationwide Routine-Data Analysis of Sex Differences in Outcome of Acute Myocardial Infarction
AU - Freisinger, Eva
AU - Sehner, Susanne
AU - Malyar, Nasser M
AU - Suling, Anna
AU - Reinecke, Holger
AU - Wegscheider, Karl
N1 - © 2018 Wiley Periodicals, Inc.
PY - 2018/8
Y1 - 2018/8
N2 - Women have been reported to suffer from impaired outcome after acute myocardial infarction (AMI). The aim of our study was to determine the impact of sex and age on utilization of inpatient healthcare and outcome in patients with AMI (STEMI and NSTEMI) in a real-life setting. We performed a routine-data-based analysis of 203 106 nationwide inpatients hospitalized with STEMI and NSTEMI, focusing on sex differences regarding risk constellation, treatments, and in-hospital outcome. A logistic regression model was designed to evaluate the use of coronary angiography and interventions and their sex-related impact on mortality (within 30 days). Compared with males, female STEMI patients (25 146, vs 52 965 males) were older and had a higher incidence of diabetes mellitus (27.4% vs 20.6%), heart failure (32.8% vs 26.2%), and chronic kidney disease (19.1% vs 13.5%, respectively; all P < 0.05), and had higher observed in-hospital mortality (STEMI, 16.9% vs 9.9%; NSTEMI, 11.7% vs 8.7%). Females were less likely to receive coronary angiography in STEMI in the age groups <60 and ≥ 80 years (odds ratio: 0.8, 95% confidence interval: 0.76-0.83, P < 0.05), despite similar mortality risk reduction. Estimated overall in-hospital mortality showed no differences with respect to sex in STEMI for age groups 40 to 79 years. However, females age ≥ 80 years had slightly higher in-hospital mortality after adjustment. The increased observed in-hospital mortality in females was attributed to the impact of more unfavorable risk and age distribution. Coronary angiography was associated with lower in-hospital mortality; particularly, older females were less frequently treated.
AB - Women have been reported to suffer from impaired outcome after acute myocardial infarction (AMI). The aim of our study was to determine the impact of sex and age on utilization of inpatient healthcare and outcome in patients with AMI (STEMI and NSTEMI) in a real-life setting. We performed a routine-data-based analysis of 203 106 nationwide inpatients hospitalized with STEMI and NSTEMI, focusing on sex differences regarding risk constellation, treatments, and in-hospital outcome. A logistic regression model was designed to evaluate the use of coronary angiography and interventions and their sex-related impact on mortality (within 30 days). Compared with males, female STEMI patients (25 146, vs 52 965 males) were older and had a higher incidence of diabetes mellitus (27.4% vs 20.6%), heart failure (32.8% vs 26.2%), and chronic kidney disease (19.1% vs 13.5%, respectively; all P < 0.05), and had higher observed in-hospital mortality (STEMI, 16.9% vs 9.9%; NSTEMI, 11.7% vs 8.7%). Females were less likely to receive coronary angiography in STEMI in the age groups <60 and ≥ 80 years (odds ratio: 0.8, 95% confidence interval: 0.76-0.83, P < 0.05), despite similar mortality risk reduction. Estimated overall in-hospital mortality showed no differences with respect to sex in STEMI for age groups 40 to 79 years. However, females age ≥ 80 years had slightly higher in-hospital mortality after adjustment. The increased observed in-hospital mortality in females was attributed to the impact of more unfavorable risk and age distribution. Coronary angiography was associated with lower in-hospital mortality; particularly, older females were less frequently treated.
KW - Adult
KW - Age Distribution
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Coronary Angiography
KW - Female
KW - Germany
KW - Hospital Mortality
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Myocardial Infarction
KW - Population Surveillance
KW - Prognosis
KW - Risk Assessment
KW - Risk Factors
KW - Sex Distribution
KW - Sex Factors
KW - Journal Article
KW - Multicenter Study
U2 - 10.1002/clc.22962
DO - 10.1002/clc.22962
M3 - SCORING: Journal article
C2 - 29667216
VL - 41
SP - 1013
EP - 1021
JO - CLIN CARDIOL
JF - CLIN CARDIOL
SN - 0160-9289
IS - 8
ER -