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Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries
AIMS: Data on how differences in risk factors, treatments, and outcomes differ between sexes in European countries are scarce. We aimed to study sex-related differences regarding baseline characteristics, in-hospital managements, and mortality of ST-elevation myocardial infarction (STEMI) patients i...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283107/ https://www.ncbi.nlm.nih.gov/pubmed/35919580 http://dx.doi.org/10.1093/ehjopen/oeac042 |
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author | Hellgren, Tora Blöndal, Mai Jortveit, Jarle Ferenci, Tamas Faxén, Jonas Lewinter, Christian Eha, Jaan Lõiveke, Piret Marandi, Toomas Ainla, Tiia Saar, Aet Veldre, Gudrun Andréka, Péter Halvorsen, Sigrun Jánosi, András Edfors, Robert |
author_facet | Hellgren, Tora Blöndal, Mai Jortveit, Jarle Ferenci, Tamas Faxén, Jonas Lewinter, Christian Eha, Jaan Lõiveke, Piret Marandi, Toomas Ainla, Tiia Saar, Aet Veldre, Gudrun Andréka, Péter Halvorsen, Sigrun Jánosi, András Edfors, Robert |
author_sort | Hellgren, Tora |
collection | PubMed |
description | AIMS: Data on how differences in risk factors, treatments, and outcomes differ between sexes in European countries are scarce. We aimed to study sex-related differences regarding baseline characteristics, in-hospital managements, and mortality of ST-elevation myocardial infarction (STEMI) patients in different European countries. METHODS AND RESULTS: Patients over the age of 18 with STEMI who were treated in hospitals in 2014–17 and registered in one of the national myocardial infarction registers in Estonia (n = 5817), Hungary (n = 30 787), Norway (n = 33 054), and Sweden (n = 49 533) were included. Cardiovascular risk factors, hospital treatment, and recommendation of discharge medications were obtained from the infarction registries. The primary outcome was mortality, in-hospital, after 30 days and after 1 year. Logistic and cox regression models were used to study the associations of sex and outcomes in the respective countries. Women were older than men (70–78 and 62–68 years, respectively) and received coronary angiography, percutaneous coronary intervention, left ventricular ejection fraction assessment, and evidence-based drugs to a lesser extent than men, in all countries. The crude mortality in-hospital rates (10.9–15.9 and 6.5–8.9%, respectively) at 30 days (13.0–19.9 and 8.2–10.9%, respectively) and at 1 year (20.3–28.1 and 12.4–17.2%, respectively) after hospitalization were higher in women than in men. In all countries, the sex-specific differences in mortality were attenuated in the adjusted analysis for 1-year mortality. CONCLUSION: Despite improved awareness of the sex-specific inequalities on managing patients with acute myocardial infarction in Europe, country-level data from this study show that women still receive less guideline-recommended management. |
format | Online Article Text |
id | pubmed-9283107 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-92831072022-08-01 Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries Hellgren, Tora Blöndal, Mai Jortveit, Jarle Ferenci, Tamas Faxén, Jonas Lewinter, Christian Eha, Jaan Lõiveke, Piret Marandi, Toomas Ainla, Tiia Saar, Aet Veldre, Gudrun Andréka, Péter Halvorsen, Sigrun Jánosi, András Edfors, Robert Eur Heart J Open Original Article AIMS: Data on how differences in risk factors, treatments, and outcomes differ between sexes in European countries are scarce. We aimed to study sex-related differences regarding baseline characteristics, in-hospital managements, and mortality of ST-elevation myocardial infarction (STEMI) patients in different European countries. METHODS AND RESULTS: Patients over the age of 18 with STEMI who were treated in hospitals in 2014–17 and registered in one of the national myocardial infarction registers in Estonia (n = 5817), Hungary (n = 30 787), Norway (n = 33 054), and Sweden (n = 49 533) were included. Cardiovascular risk factors, hospital treatment, and recommendation of discharge medications were obtained from the infarction registries. The primary outcome was mortality, in-hospital, after 30 days and after 1 year. Logistic and cox regression models were used to study the associations of sex and outcomes in the respective countries. Women were older than men (70–78 and 62–68 years, respectively) and received coronary angiography, percutaneous coronary intervention, left ventricular ejection fraction assessment, and evidence-based drugs to a lesser extent than men, in all countries. The crude mortality in-hospital rates (10.9–15.9 and 6.5–8.9%, respectively) at 30 days (13.0–19.9 and 8.2–10.9%, respectively) and at 1 year (20.3–28.1 and 12.4–17.2%, respectively) after hospitalization were higher in women than in men. In all countries, the sex-specific differences in mortality were attenuated in the adjusted analysis for 1-year mortality. CONCLUSION: Despite improved awareness of the sex-specific inequalities on managing patients with acute myocardial infarction in Europe, country-level data from this study show that women still receive less guideline-recommended management. Oxford University Press 2022-07-02 /pmc/articles/PMC9283107/ /pubmed/35919580 http://dx.doi.org/10.1093/ehjopen/oeac042 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Hellgren, Tora Blöndal, Mai Jortveit, Jarle Ferenci, Tamas Faxén, Jonas Lewinter, Christian Eha, Jaan Lõiveke, Piret Marandi, Toomas Ainla, Tiia Saar, Aet Veldre, Gudrun Andréka, Péter Halvorsen, Sigrun Jánosi, András Edfors, Robert Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries |
title | Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries |
title_full | Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries |
title_fullStr | Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries |
title_full_unstemmed | Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries |
title_short | Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries |
title_sort | sex-related differences in the management and outcomes of patients hospitalized with st-elevation myocardial infarction: a comparison within four european myocardial infarction registries |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283107/ https://www.ncbi.nlm.nih.gov/pubmed/35919580 http://dx.doi.org/10.1093/ehjopen/oeac042 |
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