Young Women Less Likely to Receive STEMI Revascularization, Have Higher In-Hospital Mortality
Younger women may be less likely to receive revascularization for ST-segment elevation myocardial infarction (STEMI) and may have higher in-hospital mortality compared with younger men, according to a study published Oct. 26 in the Journal of the American College of Cardiology.
The study analyzed 632,930 STEMI patients between the ages of 18 and 59 in the Nationwide Inpatient Sample database between 2004 and 2011. Overall, younger women were less likely than men to present with STEMI, and younger women were less likely to receive reperfusion for STEMI as compared to their younger male counterparts. However, use of percutaneous coronary intervention for STEMI and in-hospital mortality increased in both men and women during the study period.
The study also showed that young women with STEMI died at a higher rate than young men, with 4.5 percent of women in the study dying in the hospital compared to 3 percent of men. Women also had slightly longer hospital stays than men at 4.35 days versus four days on average. Researchers speculated that men may be more likely than women to die before arriving at the hospital, which might in part explain the higher rate of in-hospital mortality for younger women.
"Despite guidelines directing use of stenting in heart attack patients, younger women are receiving this life-saving treatment method less than younger men," says Deepak L. Bhatt, MD, MPH, FACC, senior author of the study. "Our research shows that there is a great opportunity and need to improve national heart attack care processes and outcomes and address these sex disparities in providing care to younger heart attack patients."
In a corresponding editorial comment, Rashmee U. Shah, MD, MS, and C. Noel Bairey Merz, MD, FACC, comment on the "methodological challenges unique to open-source data and analyses." They conclude that moving forward, "We need an ecosystem of researchers with specific expertise to standardize and validate methods and uses of crowd-sourced data to speed the pace of medical research and maximize the potential of these growing resources."
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