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Readmissions higher in women with acute MI, cardiogenic shock
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Women who had an acute MI that was complicated by cardiogenic shock were more likely to be readmitted to the hospital at 30 days compared with men, according to a study published in The American Journal of Cardiology.
Women were slightly less likely than men to undergo PCI (58.1% vs. 59.4%), the researchers reported. Women were also less likely to undergo CABG (33.1% vs. 33.4%), or intra-aortic balloon placement (37.9% vs. 39%) during the initial hospitalization compared with men.
“The findings from this study [emphasize] that further efforts and studies should be directed towards narrowing this gap between men and women,” Ahmed Mahmoud, MD, cardiovascular medicine fellow at University of Florida in Gainesville, told Cardiology Today’s Intervention. “For example, we found that women were less likely to undergo percutaneous coronary intervention/coronary artery bypass surgery, or have mechanical support devices such as intra-aortic balloons and ventricular assist devices during the index hospitalizations. These are areas that could be targeted to reduce the risk of readmissions among women.”
Mahmoud and Islam Y. Elgendy, MD, also a cardiovascular medicine fellow at University of Florida in Gainesville, analyzed data from 1,116,933 patients from the National Readmissions Database who were hospitalized for STEMI (n = 335,548) or non-STEMI (n = 781,385) from 2013 to 2014. Patients who had cardiogenic shock and were discharged alive accounted for 3.6% of the cohort, which was the major focus of the study.
The primary outcome of interest was all-cause readmission 30 days after discharge.
Among patients with cardiogenic shock discharged alive, more women were readmitted at 30 days (20.7%) vs. men (17.6%), which remained significant after adjusting for various comorbidities (adjusted HR = 1.09; 95% CI, 1-1.19) and propensity score matching based on 63 covariates (HR = 1.1; 95% CI, 1.01-1.21).
“Despite the fact that we used several statistical models to ensure that this association exists, this study is observational in nature, thus there is always a risk of unmeasured confounding,” Elgendy told Cardiology Today’s Intervention. “Also, the data source for this study lacks information about the medications which the patients received during the index hospitalization. This is an important factor since some studies had suggested that there are variations between both genders in guideline-directed therapies for acute myocardial infarction.” – by Darlene Dobkowski
For more information:
Islam Y. Elgendy, MD, can be reached at iyelgendy@gmail.com.
Ahmed Mahmoud, MD, can be reached at ahmed.mahmoud@medicine.ufl.edu.
Disclosures: Mahmoud and Elgendy report no relevant financial disclosures.
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