Sex does not affect death risk in young AMI patients

Sex does not appear to affect acute myocardial infarction (AMI) survival outcomes in younger patients, a recent US study has found.

Researchers conducted a retrospective analysis of the National Inpatient Sample including 156,018 AMI patients aged 18 to <45 years. Of these, 111,894 were men and 44,124 were women. Outcomes included in-hospital all-cause mortality, complications and revascularization studies, compared between sex groups.

AMI comorbidities occurred more frequently in women, including anaemia (15 percent vs 5.3 percent; p<0.001), chronic lung diseases (15.6 percent vs 7.5 percent; p<0.001) and obesity (31 percent vs 21.6 percent; p<0.001). The same was true for peripheral vascular disease, renal failure, and fluid and electrolyte disorders.

On the other hand, dyslipidaemia (60 percent vs 50.7 percent; p<0.001), smoking (52.7 percent vs 49.7 percent; p<0.001) and alcohol abuse (6.2 percent vs 2.2 percent; p<0.001) were significantly more common in men.

Despite these differences, survival outcomes were comparable between sexes. In-hospital all-cause mortality, for instance, occurred in 2 percent of women and 1.5 percent in men, yielding a nonsignificant difference in likelihood (odds ratio [OR], 1.04, 95 percent confidence interval [CI], 0.84–1.29; p=0.68). This held true even after analyses in different subgroups.

Women, however, were significantly less likely to receive percutaneous coronary intervention with stent placement (OR, 0.66, 95 percent CI, 0.62–0.70; p<0.001) and coronary artery bypass grafting (OR, 0.73, 95 percent CI, 0.64–0.83; p<0.001) than men.

In terms of complications, women were at a lower risk of cardiogenic shock, ventricular arrhythmia and acute kidney injury, but at a higher risk of major bleeding requiring transfusion, mitral regurgitation and respiratory failure, relative to men.