Gender Differences in In-Hospital Mortality Rates among Hispanic Patients with Acute Myocardial Infarction

Abstract

Acute myocardial infarction (AMI) is a leading cause of death in the United States with over three million cases per year. Since the mid-1970s, the total number of deaths related to AMI in the United States has not declined. Studies suggest that women with AMI have worse outcomes compared to men. However, there is limited information regarding this topic among Hispanics. This study was a secondary analysis of the Puerto Rican Heart Attack Study, which reviewed the records of Hispanic patients of Puerto Rico hospitalized for AMI at 21 academic and/or non-teaching hospitals in 2007, 2009 and 2011. This study set examined the differences in in-hospital mortality rates between genders. A p-value of 0.2 was used to select possible confounders and the chi-square test was used to examine associations between categorical variables. Factors associated with in-hospital mortality rates were identified using logistic regression. Collinearity was assessed using Pearson correlation coefficients. The 95% confidence interval and a p-value of 0.05 were used to determine statistical significance of odds ratios. Analysis was restricted to patients with ICD-9-CM code 410-414 who are above 18 (n = 2265). In our sample, there were more men than women (1291 versus 974, respectively). Men were younger and smoked more compared to women. Compared to men, women were older and suffered more comorbidities, such as stroke and congestive heart failure (CHF). Women had higher rates of in-hospital mortality compared to men (OR = 1.4, p = 0.040). Factors associated with higher rates of in-hospital mortality included age and CHF (p<0.001). Patients with CHF showed higher rates of in-hospital deaths compared to patients who did not have CHF (OR = 1.6, p = 0.026). Patients over the age of 86 showed higher odds of in-hospital death compared to younger patients (OR = 10.5, p <0.001) Significant disparities existed by gender in this sample of Hispanic AMI patients, with women showing higher in-hospital mortality compared to men. Women over 50 should perform regular checkups and discuss hormone replacement therapy or follow other preventive measures as suggested by their healthcare provider.