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Younger women less likely to receive revascularization for STEMI
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Women aged younger than 60 years were less likely to undergo revascularization for STEMI compared with men of the same age, according to a recent report.
Researchers investigated in-hospital outcomes and revascularization rates in a cohort of more than 600,000 men and women from the Nationwide Inpatient Sample who presented with STEMI from 2004 to 2011.
Among those with acute MI, younger women (< 60 years) were less likely to present with STEMI than younger men (adjusted OR = 0.74; 95% CI, 0.73-0.75). Younger women were less likely to undergo reperfusion compared with younger men; this trend was observed for PCI (adjusted OR = 0.74; 95% CI, 0.73-0.75), CABG (adjusted OR = 0.61; 95% CI, 0.6-0.62) and thrombolysis (OR = 0.8; 95% CI, 0.78-0.82).
Use of PCI for STEMI increased from 2004 to 2011 among younger men (change, 63.9% to 84.8%; P < .001 for trend) and women (change, 53.6% to 77.7%; P < .001 for trend).
The rate of in-hospital mortality was 4.5% among younger women compared with 3% among men (adjusted OR = 1.11; 95% CI, 1.07-1.15). The researchers also observed an increasing trend in risk-adjusted in-hospital mortality from 2004 to 2011 among younger women and men.
The overall length of hospital stay for younger women was 4.35 days compared with 4 days for men (adjusted parameter estimate = 1.04; 95% CI, 1.03-1.06). Length of stay decreased over the course of the study for both younger women and men. For women, length of stay declined from 4.59 days in 2004 to 4.24 days in 2011; for men, length of stay declined from 4.13 days to 3.86 days (P < .001 for trend).
“These data present a persisting opportunity to improve national STEMI care processes and outcomes, and to bridge the sex-disparity in providing care to younger patients with STEMI,” Sahil Khera, MD, from the department of medicine, division of cardiology, New York Medical College, Valhalla, New York, and colleagues concluded. – by Rob Volansky
Disclosure: Khera reports no relevant financial disclosures. Please see the full study for a list of all other authors’ financial disclosures.
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