Sex Differences in the Incidence and Outcomes of Acute Myocardial Infarction in Spain, 2016–2018: A Matched-Pair Analysis

Abstract

(1) Background: Our aim was to analyze the incidence, procedures, and in-hospital outcomes of myocardial infarction (MI) in Spain (2016–2018) according to sex. (2) Methods: We estimated the incidence of an ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) according to sex using the Spanish National Hospital Discharge Database. A matched-pair analysis was used. (3) Results: MI was coded in 156,826 patients aged ≥18 years (111,842 men and 44,984 women). Men showed higher incidence rates (205.0 vs. 77.8 per 100,000; p < 0.001; IRR = 2.81(95%CI:2.78–2.84)). After matching, the use of coronary artery by-pass grafting (CABG) (1.0% vs. 0.7%; p < 0.001) and percutaneous coronary intervention (PCI) (57.8% vs. 52.3%; p < 0.001) was higher among men with an STEMI, whereas the in-hospital mortality (IHM) remained higher among women (11.2% vs. 10.1%; p < 0.001). Likewise, CABG (1.9% vs. 3.3%; p < 0.001) and PCI (33.8% vs. 41.9%; p < 0.001) were less often used among women with an NSTEMI, but no sex-related differences were found in IHM. After adjusting for confounders, IHM was more than twofold higher for both men and women with an STEMI than those with an NSTEMI. Women with an STEMI had a 21% higher mortality risk than men (OR = 1.21(95%CI:1.13–1.29). (4) Conclusion: Men had higher incidence rates of MI than women. Women underwent invasive procedures less often and had a higher IHM when admitted for an STEMI.

Incidence, Outcomes and Sex-Related Disparities in Pneumonia: A Matched-Pair Analysis with Data from Spanish Hospitals (2016–2019)

“…As the main strengths of our study, we can put forward its large sample size, with data from over 557,000 episodes of pneumonia, the widespread coverage of the Spanish population by the RAE-CMBD (>95% of all hospital admissions) and the standardized methodology, which we have previously used [ 15 ]. Yet, we should point out several limitations.…”

“…We have used a similar methodology in previous research [ 13 , 15 ]. People older than 19 years admitted to the hospital for either CAP or who developed HAP during admission for another condition were included in the study.…”

Fear of COVID-19 in Patients with Acute Myocardial Infarction

“…However, this fact is representative of the clinical AMI reality, where there is a male:female event ratio of 5:1 [ 36 ]. However, despite the lower incidence of acute coronary artery disease in females, women have worse short- and long-term outcomes than men [ 37 , 38 ]. Moreover, the pre-hospital delay from symptom onset to admission is generally significantly longer for women also ordinarily [ 39 ].…”

Incidence and Outcomes of Hemorrhagic Stroke among Adults in Spain (2016–2018) According to Sex: A Retrospective, Cohort, Observational, Propensity Score Matched Study

“…Our main study variables were the incidence of HS, the use of decompressive craniectomy and the IHM. Incidence rates were calculated using the Spanish populations by year, sex and age groups, provided by the Spanish National Statistics Institute as described before [12,13]. Patients were classified as receivers of a decompressive craniectomy if any of the codes for this procedure (Table S1) appeared in any of the 20 procedure fields.…”