Sex-based differences in clinical outcomes and resource utilization of type 2 myocardial infarction

Sex-based differences in clinical outcomes have been previously well described in type 1 myocardial infarction (T1MI). However, type 2 myocardial infarction (T2MI) is more common in contemporary practice, with scarce data regarding sex-based differences of outcomes. The Nationwide Readmission Databa...

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Bibliographic Details
Published in:International journal of cardiology 2021-09, Vol.338, p.24-29
Main Authors: Ariss, Robert W., Elzanaty, Ahmed M., Minhas, Abdul Mannan Khan, Nazir, Salik, Gul, Sajjad, Patel, Neha, Ahuja, Keerat Rai, Mochon, Agnieszka, Eltahawy, Ehab A.
Format: Article
Language:English
Subjects:
Gender difference
National readmission database
Sex-difference
Type 2 myocardial infarction
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Summary:Sex-based differences in clinical outcomes have been previously well described in type 1 myocardial infarction (T1MI). However, type 2 myocardial infarction (T2MI) is more common in contemporary practice, with scarce data regarding sex-based differences of outcomes. The Nationwide Readmission Database 2018 was queried for hospitalizations with T2MI as a primary or secondary diagnosis. Complex samples multivariable logistic and linear regression models were used to determine the association between T2MI and outcomes (in-hospital mortality, index length of stay [LOS], hospital costs, discharge to nursing facility, and 30-day all-cause readmissions) in females compared to males with T2MI. A total of 252,641 hospitalizations [119,783 (47.4%) females and 132,858 (52.6%) males] were included in this analysis. Females with T2MI was associated with lower in-hospital mortality (adjusted odds ratio [aOR] 0.92; 95% confidence interval [CI] 0.88–0.96; P < 0.001), shorter LOS (adjusted parameter estimate [aPE] −0.28; 95% CI −0.38–0.17; P < 0.001), less hospital costs (aPE -1510.70; 95% CI −1916.04–1105.37; P < 0.001), and increased nursing home discharges (aOR 1.08; 95% CI 1.05–1.12; P < 0.001) compared to males with T2MI. Females and males with T2MI had similar rates of 30-day all-cause readmission (aOR 1.00; 95% CI 0.97–1.04; P = 0.841). Among T2MI hospitalizations, females have lower in-hospital mortality, hospitalization costs, shorter LOS, and increased rates of nursing home discharge compared to males. Although statistically significant, the clinical significance of these small differences are unknown and require future studies. •This is one of the largest retrospective studies looking into the impact of sex on T2MI.•Females have lower in-hospital mortality, shorter LOS, and fewer hospitalization costs.•Females have higher rates of discharge to nursing homes.•Both males and females have similar 30-days readmission rates.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2021.05.043