Sex‐Based Differences in Outcomes After Percutaneous Coronary Intervention for Acute Myocardial Infarction: A Report From TRANSLATE‐ACS

Hess, Connie N.; McCoy, Lisa A.; Duggirala, Hesha J.; Tavris, Dale R.; O’Callaghan, Kathryn M.; Douglas, Pamela S.; Peterson, Eric D.; Wang, Tracy Y.

doi:10.1161/jaha.113.000523

Cited by 101 publications

(88 citation statements)

References 48 publications

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“…One-year MACE included composite of all-cause death, MI, stroke, or unplanned revascularisation. However, female sex was no longer associated with higher incidence of MACE after multivariable adjustment ( HR 0.98, 95% CI 0.83 to 1.15) 12. While in contrast, a European analysis including 74 389 patients from the French nationwide hospitals database showed that a 30% excess in mortality persists among women even after age and comorbidities are taken into account 3…”

Section: Differences In Outcomes: Is Gender An Independent Prognosticmentioning

confidence: 99%

Gender differences in coronary heart disease

Khamis

Ammari

Mikhail

2016

Heart

128

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Section: Differences In Outcomes: Is Gender An Independent Prognosticmentioning

confidence: 99%

Gender differences in coronary heart disease

Khamis

Ammari

Mikhail

2016

Heart

128

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“…352 Women continue to have almost twice the rate of bleeding after PCI as men. 249,353 It is prudent to pay careful attention by guest on http://circ.ahajournals.org/ Downloaded from to body weight, renal function, and dosing guidelines in women. 349,350 It is also important to continue evaluating for effective strategies to limit post-PCI bleeding in women.…”

Section: Bleeding Complicationsmentioning

confidence: 99%

Acute Myocardial Infarction in Women

Mehta¹,

Beckie²,

DeVon³

et al. 2016

Circulation

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941

393

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Cardiovascular disease is the leading cause of mortality in American women. Since 1984, the annual cardiovascular disease mortality rate has remained greater for women than men; however, over the last decade, there have been marked reductions in cardiovascular disease mortality in women. The dramatic decline in mortality rates for women is attributed partly to an increase in awareness, a greater focus on women and cardiovascular disease risk, and the increased application of evidence-based treatments for established coronary heart disease. This is the first scientific statement from the American Heart Association on acute myocardial infarction in women. Sex-specific differences exist in the presentation, pathophysiological mechanisms, and outcomes in patients with acute myocardial infarction. This statement provides a comprehensive review of the current evidence of the clinical presentation, pathophysiology, treatment, and outcomes of women with acute myocardial infarction.

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“…Studies have reported less use of glycoprotein IIb/IIIa inhibitors, coronary revascularization, and statins at discharge in black versus white and female versus male MI patients. [4][5][6][9][10][11][12] Data also show that, after an initial MI event, black and female patients have greater risk of short-and long-term mortality, recurrent MI, heart failure, and stroke than white and male patients, respectively. 3 In the Medicare population, higher 30-day readmission rates for black versus white MI patients have been observed, 13 whereas, among the younger MI population (<65 years old), women have higher rates of 30-day readmission than men.…”

Section: Discussionmentioning

confidence: 96%

“…Although the incidence of hospitalized MI has decreased over the past 2 decades, rates of decline have been lower for black than for white patients, 3 and racial and sex disparities in the treatment of MI and in clinical outcomes post-MI have been described. [3][4][5][6][7][8][9][10][11][12] Significant differences in 30-day readmissions after MI between races and sexes have also been observed. 13,14 Eliminating such disparities is a national priority, 15 but achieving this goal will require a better understanding of contributing factors.…”

mentioning

confidence: 99%

Race and Sex Differences in Post–Myocardial Infarction Angina Frequency and Risk of 1-Year Unplanned Rehospitalization

et al. 2017

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ORIGINAL RESEARCH ARTICLEBACKGROUND: Race and sex disparities in in-hospital treatment and outcomes of patients with acute myocardial infarction (MI) have been described, but little is known about race and sex differences in post-MI angina and long-term risk of unplanned rehospitalization. We examined race and sex differences in post-MI angina frequency and 1-year unplanned rehospitalization to identify factors associated with unplanned rehospitalization, testing for whether race and sex modify these relationships. METHODS: Using TRANSLATE-ACS (Treatment With Adenosine DiphosphateReceptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome) data, we examined 6-week and 1-year angina frequency and 1-year unplanned rehospitalization stratified by race and sex among MI patients treated with percutaneous coronary intervention. We used multivariable logistic regression to assess factors associated with unplanned rehospitalization and tested for interactions among angina frequency, race, and sex. RESULTS:A total of 11 595 MI patients survived to 1 year postdischarge; there were 66.6% white male patients, 24.3% white female patients, 5.3% black male patients, and 3.8% black female patients. Overall, 29.7% had angina at 6 weeks, and 20.6% had angina at 1 year postdischarge. Relative to white patients, black patients were more likely to have angina at 6 weeks (female: 44.2% versus 31.8%; male: 33.5% versus 27.1%; both P<0.0001) and 1 year (female: 49.4% versus 38.9%; male: 46.3% versus 31.1%; both P<0.0001). Rates of 1-year unplanned rehospitalization were highest among black female patients (44.1%), followed by white female patients (38.4%), black male patients (36.4%), and white male patients (30.2%, P<0.0001). In the multivariable model, 6-week angina was most strongly associated with unplanned rehospitalization (hazard ratio, 1.49; 95% confidence interval, 1.36-1.62; P<0.0001); this relationship was not modified by race or sex (adjusted 3-way P interaction =0.41). CONCLUSIONS:One-fifth of MI patients treated with percutaneous coronary intervention report 1-year postdischarge angina, with black and female patients more likely to have angina and to be rehospitalized. Better treatment of post-MI angina may improve patient quality of life and quality of care and help to lower rates of rehospitalization overall and particularly among black and female patients, given their high prevalence of post-MI angina.

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Sex‐Based Differences in Outcomes After Percutaneous Coronary Intervention for Acute Myocardial Infarction: A Report From TRANSLATE‐ACS

Cited by 101 publications

References 48 publications

Gender differences in coronary heart disease

Gender differences in coronary heart disease

Acute Myocardial Infarction in Women

Race and Sex Differences in Post–Myocardial Infarction Angina Frequency and Risk of 1-Year Unplanned Rehospitalization

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