Sex differences in heart failure hospitalisation risk following acute myocardial infarction

Yandrapalli, Srikanth; Malik, Aaqib H; Pemmasani, Gayatri; Aronow, Wilbert S.; Shah, Falak; Lanier, Gregg; Cooper, Howard A.; Jain, Diwakar; Naidu, Srihari S.; Frishman, William H.; Panza, Julio A.

doi:10.1136/heartjnl-2020-318306

Cited by 14 publications

(10 citation statements)

References 28 publications

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“…Among 237 549 AMI survivors in the US Nationwide Readmissions Database, sex differences in HF hospitalization risk were explored. 18 In a propensity-matched time-to-event analysis, females had a 13% higher risk of 6-month HF readmission compared with males (6.4% versus 5.8%; HR, 1.13 [95% CI, 1.05–1.21]; P <0.001).…”

Section: Quality Of Carementioning

confidence: 98%

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Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,530

702

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BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year’s worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Section: Quality Of Carementioning

confidence: 98%

“…An analysis of the US Nationwide Readmissions Database determined that after hospitalization for AMI, females had 13% increased risk of 6-month HF hospitalization compared with males (6.4% in females versus 5.8% in males; HR, 1.13 [95% CI, 1.05–1.21]). 111…”

Section: Coronary Heart Disease Acute Coronary Syndrome and Angina Pe...mentioning

confidence: 99%

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,530

702

View full text Add to dashboard Cite

show abstract

“…Furthermore, our pilot study reflects a “real-life” population as it included all consecutive diabetic patients hospitalised with AHF during the study period. Interestingly, the RR for GV > 50 mg/dL was superior to that for age > 75 years, reduced LVEF and female sex, three well-known cardiovascular parameters associated with the occurrence of MACE [ 29 , 30 , 31 ]. In addition, GV seems to be a better predictive factor of mid-term MACE than worsening renal failure and BNP in diabetic patients with AHF, whereas these markers usually provide robust prognostic information in all patients with AHF [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Glycaemic Variability and Hyperglycaemia as Prognostic Markers of Major Cardiovascular Events in Diabetic Patients Hospitalised in Cardiology Intensive Care Unit for Acute Heart Failure

Gerbaud

Poterie

Baudinet

et al. 2022

JCM

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(1) Background: Hyperglycaemia and hypoglycaemia are both emerging risk factors for cardiovascular disease. Nevertheless, the potential effect of glycaemic variability (GV) on mid-term major cardiovascular events (MACE) in diabetic patients presenting with acute heart failure (AHF) remains unclear. This study investigates the prognostic value of GV in diabetic patients presenting with acute heart failure (AHF). (2) Methods: this was an observational study including consecutive patients with diabetes and AHF between January 2015 and November 2016. GV was calculated using standard deviation of glycaemia values during initial hospitalisation in the intensive cardiac care unit. MACE, including recurrent AHF, new-onset myocardial infarction, ischaemic stroke and cardiac death, were recorded. The predictive effects of GV on patient outcomes were analysed with respect to baseline characteristics and cardiac status. (3) Results: In total, 392 patients with diabetes and AHF were enrolled. During follow-up (median (interquartile range) 29 (6–51) months), MACE occurred in 227 patients (57.9%). In total, 92 patients died of cardiac causes (23.5%), 107 were hospitalised for heart failure (27.3%), 19 had new-onset myocardial infarction (4.8%) and 9 (2.3%) had an ischaemic stroke. Multivariable logistic regression analysis showed that GV > 50 mg/dL (2.70 mmol/L), age > 75 years, reduced left ventricular ejection fraction (LVEF < 30%) and female gender were independent predictors of MACE: hazard ratios (HR) of 3.16 (2.25–4.43; p < 0.001), 1.54 (1.14–2.08; p = 0.005), 1.47 (1.06–2.07; p = 0.02) and 1.43 (1.05–1.94; p = 0.03), respectively. (4) Conclusions: among other well-known factors of HF, a GV cut-off value of >50 mg/dL was the strongest independent predictive factor for mid-term MACE in patients with diabetes and AHF.

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“…The study sample included all patients ≥ 18 years who were discharged alive, and who are therefore at risk of readmission, between January and June 2014 with a primary discharge diagnosis of an AMI (International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes 410.x1). NRD 2014 was utilized because it is the latest yearly dataset that allows ICD-9 based analysis which was previously validated to study HF outcomes [16,17]. This time period was chosen so that our study patients could be tracked until the end of 2014 for any HF hospitalization, thereby allowing for analysis of 6-month readmissions.…”

Section: Patient Population and Baseline Characteristicsmentioning

confidence: 99%

Impact of chronic obstructive pulmonary disease on heart failure hospitalizations after an acute myocardial infarction

Yandrapalli¹,

Pandit²,

Malik³

et al. 2023

Arch Med Sci Atheroscler Dis

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IntroductionThe presence of chronic obstructive pulmonary disease (COPD) can impact the management of acute myocardial infarction (AMI) and is associated with higher mortality. Few studies addressed COPD impact on heart failure hospitalisations (HFHs) in AMI survivors.Material and methodsAdult survivors of an AMI between January and June 2014 were identified from the US Nationwide Readmissions Database. The impact of COPD on HFH within 6 months, fatal HFH and the composite of in-hospital HF or 6-month HFH was studied.ResultsOf 237,549 AMI survivors, patients with COPD (17.5%) were older, more likely female, had a higher prevalence of cardiac comorbidities and a lower coronary revascularization rate. In-hospital HF was more frequent in patients with COPD (47.0% vs. 25.4%; p < 0.001). HFH within 6 months occured in 12,934 (5.4%) patients, at a 114% higher rate in patients with COPD (9.4% vs. 4.6%, OR = 2.14, 95% CI : 2.01–2.29; p < 0.001), which was attenuated to a 39% higher adjusted risk (OR = 1.39, 95% CI: 1.30–1.49). Findings were consistent across subgroups of age, AMI type, and major HF risk factors. Mortality during a HFH (5.7% vs. 4.2%, p < 0.001) and the rate of the composite HF outcome (49.0% vs. 26.9%, p < 0.001) were significantly higher in patients with COPD.ConclusionsCOPD was present in 1 of 6 AMI survivors and was associated with worse HF related outcomes. The increased HFH rate in COPD patients was consistent across several clinically relevant subgroups and these findings highlight the need for optimal in-hospital and post-discharge management of these higher-risk patients.

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Sex differences in heart failure hospitalisation risk following acute myocardial infarction

Cited by 14 publications

References 28 publications

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Glycaemic Variability and Hyperglycaemia as Prognostic Markers of Major Cardiovascular Events in Diabetic Patients Hospitalised in Cardiology Intensive Care Unit for Acute Heart Failure

Impact of chronic obstructive pulmonary disease on heart failure hospitalizations after an acute myocardial infarction

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