Sex disparities persist in diagnosis and procedures for acute myocardial infarction
Click Here to Manage Email Alerts
Key takeaways:
- Sex disparities in diagnosis and treatment of STEMI have declined, but the trends in non-STEMI have been inconsistent.
- In-hospital mortality after CABG or PCI remains higher for women in many cases.
Despite recent improvements, sex disparities in diagnostic evaluation and revascularization procedures still exist for patients with STEMI and non-STEMI, according to data published in the Journal of the American Heart Association.
“Improvement in sex-based trends in diagnostic evaluation and revascularization for STEMI is reassuring; however, similar trends were not seen for non-STEMI; hence, continued national quality improvement initiatives are needed for these patients,” Muddasir Ashraf, MD, postdoctoral research fellow at Aurora St. Luke’s Medical Center in Milwaukee, and colleagues wrote.
Image: Adobe Stock
In a study of 9,259,932 patients with acute MI (39% women; 72% with non-STEMI) using the National Inpatient Sample data from 2005 to 2019, researchers evaluated sex-based trends over five 3-year periods.
Among patients with non-STEMI, 42% were women, and among those with STEMI, 32% were women.
For patients with non-STEMI, the researchers found a small reduction in sex disparity in the use of all diagnostic angiography by the fifth period vs. the first (P < .01). However, there was no change in the disparity in PCI use (P = .16), and an even wider disparity in CABG use (P < .01). Furthermore, in patients with non-STEMI, risk-adjusted in-hospital mortality was higher after CABG for women vs. men.
For patients with STEMI, the researchers found a decrease in sex disparity in the use of diagnostic angiography (P < .05), PCI (P < .05) and CABG (P < .05). Risk-adjusted in-hospital mortality in patients with STEMI was higher after PCI and CABG for women compared with men.
“We saw much more significant improvement in sex disparities in rates of all diagnostic angiograms, PCIs and CABG for patients with STEMI,” Ashraf and colleagues wrote. “Despite these trends, disparities still exist in using these procedures for both patients with non-STEMI and patients with STEMI.”
Collapse
Click Here to Manage Email Alerts