TY - JOUR
T1 - Age-Related Sex Differences in Clinical Presentation, Management, and Outcomes in ST-Segment–Elevation Myocardial Infarction
T2 - Pooled Analysis of 15 532 Patients From 7 Arabian Gulf Registries
AU - Shehab, Abdulla
AU - Bhagavathula, Akshaya Srikanth
AU - Alhabib, Khalid F.
AU - Ullah, Anhar
AU - Suwaidi, Jassim Al
AU - Almahmeed, Wael
AU - AlFaleh, Hussam
AU - Zubaid, Mohammad
N1 - Publisher Copyright:
© 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2020/2/18
Y1 - 2020/2/18
N2 - Background: No studies from the Arabian Gulf region have taken age into account when examining sex differences in ST-segment–elevation myocardial infarction (STEMI) presentation and outcomes. We examined the relationship between sex differences and presenting characteristics, revascularization procedures, and in-hospital mortality after accounting for age in patients hospitalized with STEMI in the Arabian Gulf region from 2005 to 2017. Methods and Results: This study was a pooled analysis of 31 620 patients with a diagnosis of acute coronary syndrome enrolled in 7 Arabian Gulf registries. Of these, 15 532 patients aged ≥18 years were hospitalized with a primary diagnosis of STEMI. A multiple variable regression model was used to assess sex differences in revascularization, in-hospital mortality, and 1-year mortality. Odds ratios and 95% CIs were calculated. Women were, on average, 8.5 years older than men (mean age: 61.7 versus 53.2 years; absolute standard mean difference: 68.9%). The age-stratified analysis showed that younger women (aged <65 years) with STEMI were more likely to seek acute medical care and were less likely to receive thrombolytic therapies or primary percutaneous coronary intervention and guideline-recommended pharmacotherapy than men. Women had higher crude in-hospital mortality than men, driven mainly by younger age (46–55 years, odds ratio: 2.60 [95% CI, 1.80–3.7]; P<0.001; 56–65 years, odds ratio: 2.32 [95% CI, 1.75–3.08]; P<0.001; and 66–75 years, odds ratio: 1.79 [95% CI, 1.33–2.41]; P<0.001). Younger women had higher adjusted in-hospital and 1-year mortality rates than younger men (P<0.001). Conclusions: Younger women (aged ≤65 years) with STEMI were less likely to receive guideline-recommended pharmacotherapy and revascularization than younger men during hospitalization and had higher in-hospital and 1-year mortality rates.
AB - Background: No studies from the Arabian Gulf region have taken age into account when examining sex differences in ST-segment–elevation myocardial infarction (STEMI) presentation and outcomes. We examined the relationship between sex differences and presenting characteristics, revascularization procedures, and in-hospital mortality after accounting for age in patients hospitalized with STEMI in the Arabian Gulf region from 2005 to 2017. Methods and Results: This study was a pooled analysis of 31 620 patients with a diagnosis of acute coronary syndrome enrolled in 7 Arabian Gulf registries. Of these, 15 532 patients aged ≥18 years were hospitalized with a primary diagnosis of STEMI. A multiple variable regression model was used to assess sex differences in revascularization, in-hospital mortality, and 1-year mortality. Odds ratios and 95% CIs were calculated. Women were, on average, 8.5 years older than men (mean age: 61.7 versus 53.2 years; absolute standard mean difference: 68.9%). The age-stratified analysis showed that younger women (aged <65 years) with STEMI were more likely to seek acute medical care and were less likely to receive thrombolytic therapies or primary percutaneous coronary intervention and guideline-recommended pharmacotherapy than men. Women had higher crude in-hospital mortality than men, driven mainly by younger age (46–55 years, odds ratio: 2.60 [95% CI, 1.80–3.7]; P<0.001; 56–65 years, odds ratio: 2.32 [95% CI, 1.75–3.08]; P<0.001; and 66–75 years, odds ratio: 1.79 [95% CI, 1.33–2.41]; P<0.001). Younger women had higher adjusted in-hospital and 1-year mortality rates than younger men (P<0.001). Conclusions: Younger women (aged ≤65 years) with STEMI were less likely to receive guideline-recommended pharmacotherapy and revascularization than younger men during hospitalization and had higher in-hospital and 1-year mortality rates.
KW - Middle East
KW - STEMI
KW - acute coronary syndrome
KW - hospitalization
KW - mortality
KW - myocardial infarction
KW - sex
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U2 - 10.1161/JAHA.119.013880
DO - 10.1161/JAHA.119.013880
M3 - Article
C2 - 32063127
AN - SCOPUS:85079523617
SN - 2047-9980
VL - 9
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 4
M1 - e013880
ER -