Sex differences in trends and in-hospital outcomes of acute myocardial infarction in patients with familial hypercholesterolemia: insights from a large national database

ABSTRACT

Background

Sex differences in clinical outcomes following acute myocardial infarction (AMI) are well known. However, data on sex differences among patients with familial hypercholesterolemia (FH) are limited. We aimed to explore sex differences in outcomes of AMI among patients with FH from a national administrative dataset.

Research design and methods

We utilized the National Inpatient Sample to identify admissions with a primary diagnosis of AMI and a secondary diagnosis of FH. Our primary outcome of interest was in-hospital mortality; secondary outcomes were performance of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), respiratory complications, use of inotropes, use of mechanical circulatory support (MCS), bleeding complications, transfusion and facility discharge. We adjusted for demographics (model A), comorbidities (model B), and intervention (model C).

Results

Between October 2016 and December 2020, 5,714,993 admissions with a primary diagnosis of AMI were identified, of which 3,035 (0.05%) had a secondary diagnosis of FH. In-hospital mortality did not differ between men and women (Model C, adjusted OR = 0.85; 95% CI 0.28–2.60, p = 0.773). There was no sex difference in the secondary outcomes.

Conclusion

Despite generally being older and having more comorbidities, women with FH fair equally with men with FH in terms of mortality during AMI admission.

KEYWORDS:

• Sex differences
• acute myocardial infarction
• familial hypercholesterolemia
• cardiovascular outcomes
• Sex disparities

Declaration of interest

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.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14779072.2024.2329720

Reviewer declarations

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

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.

Author contributions

FB Rivera, SW Cha, S Redula, N Shah: Conceptualization, Methodology, Software; FB Rivera, N Bantayan, MB Liston, S Redula: Data curation, Writing- Original draft preparation. SW Cha, N Bantayan, S Redula, FB Rivera, N Shah: Visualization, Investigation. N Shah, AS Volgman, M Mamas: Supervision. S Redula, FB Rivera: Software, Validation: N Shah, SW Cha, M Mamas, AS Volgman: Writing- Reviewing and Editing

Additional information

Funding

This paper was not funded.