Sex differences in trends and outcomes of acute myocardial infarction with mechanical complications in the United States

ABSTRACT

Background

Mechanical complications (MC) are rare but significant sequelae of acute myocardial infarction (AMI). Current data on sex differences in AMI with MC is limited.

Methods

We queried the National Inpatient Sample database to identify adult patients with the primary diagnosis of AMI and MC. The main outcome of interest was sex difference in-hospital mortality. Secondary outcomes were sex differences in the incidence of acute kidney injury (AKI), major bleeding, use of inotropes, permanent pacemaker implantation (PPMI), performance of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), surgery (VSD repair and MV surgery), pericardiocentesis, use of mechanical circulatory support (MCS), ischemic stroke, and mechanical ventilation.

Results

Among AMI-MC cohort, in-hospital mortality was higher among females compared to males (41.24% vs 28.13%: aOR 1.39. 95% CI 1.079–1.798; p = 0.01). Among those who had VSD, females also had higher in-hospital mortality compared to males (56.7% vs 43.1%: aOR 1.74, 95% CI 1.12–2.69; p = 0.01). Females were less likely to receive CABG compared to males (12.03% vs 20%: aOR 0.49 95% CI 0.345–0.690; p < 0.001).

Conclusion

Despite the decreasing trend in AMI admission, females had higher risk of MC and associated mortality. Significant sex disparities still exist in AMI treatment.

KEYWORDS:

• Sex differences
• myocardial infarction
• mechanical complications
• papillary muscle rupture
• ventricular septal defect
• in-hospital mortality
• admission trend
• trends

Disclosures

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

FB Rivera: Conceptualization; Data curation; Formal analysis; Investigation; Methodology; Validation; Writing – original draft; Writing – review & editing; WF Salva, JS Gonzales, SW Cha, S Tang: Writing – Data curation; review & editing; FB Rivera; GNO Lumbang; G Kaur, MI Planek: Data Curation; Writing – original draft; Writing – review & editing; FB Rivera: Writing – original draft; Writing – review & editing; WF Salva, J Gonzales: Data curation; Data interpretation; Formal analysis; Writing – original draft; Writing – review & editing; FMS Collado, TMB Suboc, M Dela Cruz, JR Enriquez, K Lara-Breitinger, NP Shah: Writing – original draft; Writing – review & editing; AS Volgman: Writing – review & editing.

Ethic statement

Ethics approval for this paper is not required because this study is based exclusively on published literature. Patient consent was not needed as this study was based on publicly available data.

Data availability statement

All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14779072.2024.2311707

Additional information

Funding

This paper was not funded.