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Women with Acute Myocardial Infarction: Clinical Characteristics, Treatment, and In-Hospital Outcomes from a Latin American Country Cover

Women with Acute Myocardial Infarction: Clinical Characteristics, Treatment, and In-Hospital Outcomes from a Latin American Country

Global Heart
Volume 18 (2023): Issue 1
By: Alexandra Arias-Mendoza,  Héctor González-Pacheco,  Amada Álvarez-Sangabriel,  Rodrigo Gopar-Nieto,  Laura Leticia Rodríguez-Chávez,  Diego Araiza-Garaygordobil,  Pamela Ramírez-Rangel,  Daniel Sierra-Lara Martínez,  María del Carmen Lacy-Niebla,  José Luis Briseño-De la Cruz,  Jessica Juárez-Tolen,  Salvador Mendoza-García and  Alfredo Altamirano-Castillo  
Open Access
|Apr 2023
Figures & tables

Figures & Tables

Figure 1

Flow chart illustrating the study sample selection.

Table 1

Baseline characteristics of patients with STEMI and NSTEMI.

STEMINSTEMI
WOMEN
(N = 1,241)		MEN
(N = 6,358)		P-VALUEWOMEN
(N = 1,130)		MEN
(N = 3,340)		P-VALUE
Age (years)Median (IQR), (n = 12,051)65 (57–74)58 (51–65)<0.000167 (60–75)62 (54–70)<0.0001
BMI (kg/m2)Median (IQR), (n = 12,050)26.6 (23.9–29.4)27.2 (24.9–29.4)<0.000126.6 (24–29.4)26.9 (24.8–29.7)<0.0001
Current/recent smoker, n (%)239 (19.3)2,381 (37.4)<0.0001128 (11.3)784 (23.5)<0.0001
Hypertension, n (%)818 (65.9)2,842 (44.7)<0.0001886 (78.4)2,080 (62.3)<0.0001
Dyslipidemia, n (%)349 (28.1)1,850 (29.1)0.25470 (41.6)1,523 (45.6)0.20
Diabetes, n (%)638 (51.4)2,254 (35.5)<0.0001598 (52.9)1,333 (39.9)<0.0001
Prior myocardial infarction, n (%)110 (8.9)903 (14.2)<0.0001389 (34.4)1,562 (46.8)<0.0001
Prior PCI, n (%)56 (4.5)509 (8.0)<0.0001189 (16.7)839 (25.1)<0.0001
Prior CABG, n (%)12 (1.0)70 (1.1)0.4066 (5.8)272 (8.1)0.01
Prior stroke, n (%)38 (3.1)119 (1.9)<0.000147 (4.2)99 (3.0)0.05
Prior heart failure, n (%)43 (3.5)210 (3.3)0.73208 (18.4)535 (16.0)0.06
Atrial fibrillation, n (%)32 (2.6)48 (0.8)<0.000173 (6.5)97 (2.9)<0.0001
Prior use of aspirin, n (%)228 (18.4)1,160 (18.2)0.90564 (49.9)1,798 (53.8)0.02
Prior use of P2Y12 receptor inhibitors, n (%)48 (3.9)289 (4.5)0.28163 (14.4)564 (16.9)0.05
Prior use of beta blockers, n (%)210 (16.9)756 (11.9)<0.0001447 (39.6)1,271 (38.1)0.37
Prior use of statin, n (%)156 (12.6)918 (14.1)0.09529 (46.8)1,718 (51.4)<0.0001
Prior use of ACEI/ARB (%), n (%)574 (46.3)2,011 (31.6)<0.0001702 (62.1)1,781(53.3)<0.0001

[i] STEMI: ST-segment elevation myocardial infarction; NSTEMI: non-ST-elevation myocardial infarction; IQR: interquartile range; BMI: body mass index; PCI: percutaneous coronary intervention; CABG: coronary artery bypass grafting; ACEI/ARB: angiotensin-converting enzyme inhibitors/angiotensin receptor blocker.

Table 2

Characteristics at admission.

STEMINSTEMI
WOMEN
(N = 1,241)		MEN
(N = 6,358)		P-VALUEWOMEN
(N = 1,130)		MEN
(N = 3,340)		P-VALUE
Systolic blood pressure (mmHg)Median (IQR), (n = 12,044)125 (110–145)128 (110–138)0.04132 (120–150)130 (120–150)<0.0001
Heart rate (beats/min)Median (IQR), (n = 12,040)80 (70–92)80 (70–91)0.5679 (70–90)76 (68–89)<0.0001
Killip class II–IVn (%)619 (49.9)2,430 (38.2)<0.0001429 (38)929 (27.8)<0.0001
Anterior wall location n (%)558 (45)3100 (48.8)0.01–––
Time from symptom onset to arrival (hours)Median (IQR), (n = 11,972)14:17 (5:18–45:33)10:56 (4:09–36:38)<0.00019:24(4:00–24:49)8:52 (3:48–23:30)0.32
LVEF (%)Median (IQR), (n = 11,378)50 (40–55)50 (40–55)0.2053 (42–60)51 (40–58)<0.0001
Admission blood glucose level (mg/dL)Median (IQR), (n = 12,004)159 (119–233)143 (114–207)<0.0001138 (106–211)123 (101–173)<0.0001
Hemoglobin (g/L)Median (IQR), (n = 12,045)13.2 (12–14.4)15.4 (14–16.5)<0.000113.0 (11.6–14.2)15.0 (13.6–16)<0.0001
Creatinine (mg/dL)Median (IQR), (n = 12,046)1.0 (0.8–1.4)1.0 (0.7–1.2)0.300.9 (0.7–1.3)1.0 (0.9–1.3)0.15
Creatinine clearance(mg/dL)n (%)<30 mL/h151 (12.2)326 (5.1)<0.0001168 (14.9)246 (7.4)<0.0001
30–59 mL/h385 (31.0)979 (15.4)399 (35.3)732 (21.9)
>60 mL/h705 (56.8)5,053 (79.5)563 (49.8)2,362 (70.7)

[i] STEMI: ST-segment elevation myocardial infarction; NSTEMI: non-ST-elevation myocardial infarction; IQR: interquartile range; LVEF: left ventricular ejection fraction.

Table 3

In-hospital management.

STEMINSTEMI
WOMEN
(N = 1,241)		MEN
(N = 6,358)		P-VALUEWOMEN
(N = 1,130)		MEN
(N = 3,340)		P-VALUE
Reperfusion therapy, n (%)680 (54.8)4,047(63.7)<0.0001
—Primary PCI, n (%)387 (31.2)2,233 (35.1)<0.0001
—In-hospital thrombolysis, n (%)90 (7.3)524 (8.2)<0.0001
—Out-of-hospital thrombolysis, n (%)203 (16.4)1,290 (20.3)<0.0001
Coronary angiography, n (%)1,002 (80.7)5,575 (87.7)<0.0001799 (70.7)2,626 (78.6)<0.0001
No primary PCI, n (%)485 (39.1)2,673 (42.0)0.05415 (36.7)1,621 (48.5)<0.0001
Aspirin, n (%)1,224 (98.6)6,302 (99.1)0.101,115 (98.7)3,297 (98.7)0.91
P2Y12 receptor inhibitors, n (%)1,044 (84.1)5,681 (89.4)<0.0001813 (71.9)2,539 (76.0)0.006
Heparin, n (%)1,215 (97.9)6,276 (98.7)0.021,107 (98.0)3,270 (97.9)0.90
Statin, n (%)1,212 (97.7)6,248 (98.)0.141,101 (97.4)3,258 (97.5)0.83
Beta blockers, n (%)617 (49.7)3,941 (62.0)<0.0001726 (64.2)2,308 (69.1)0.003
ACEI/ARB (%), n (%)997 (80.)5,530 (87.0)<0.0001972 (86.0)2,957 (88.5)0.02

[i] STEMI: ST-elevation myocardial infarction; NSTEMI: non-ST-elevation myocardial infarction; PCI: percutaneous coronary intervention; ACEI/ARB: angiotensin-converting enzyme inhibitors/angiotensin receptor blocker.

Figure 2

Overall in-hospital all-cause mortality rates of the 12,069 CCU admissions with acute myocardial infarction. In-hospital all-cause mortality rates among 7,599 patients with ST-elevation myocardial infarction and 4,470 patients with non-ST-elevation myocardial infarction.

Figure 3

Temporal trends from 2006 to 2021 in rates of all-cause in-hospital mortality: (A) In patients with ST-elevation myocardial infarction. (B) In patients with non-ST-elevation myocardial infarction.

Figure 4

Cox regression model: (A) Independent predictors of in-hospital all-cause mortality in patients with ST-elevation myocardial infarction. (B) Independent predictors of in-hospital all-cause mortality in patients with non-ST-elevation myocardial infarction.

Figure 5

In-hospital adverse events in patients with ST-elevation myocardial infarction.

DOI: https://doi.org/10.5334/gh.1196 | Journal eISSN: 2211-8179
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Language: English
Submitted on: Nov 23, 2022
Accepted on: Mar 27, 2023
Published on: Apr 20, 2023
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
women,
acute coronary syndromes,
treatment,
diagnosis,
gender differences

© 2023 Alexandra Arias-Mendoza, Héctor González-Pacheco, Amada Álvarez-Sangabriel, Rodrigo Gopar-Nieto, Laura Leticia Rodríguez-Chávez, Diego Araiza-Garaygordobil, Pamela Ramírez-Rangel, Daniel Sierra-Lara Martínez, María del Carmen Lacy-Niebla, José Luis Briseño-De la Cruz, Jessica Juárez-Tolen, Salvador Mendoza-García, Alfredo Altamirano-Castillo, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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