Abstract
AbstractBackgroundYounger women have higher recurrent hospitalization rates and worse health status than men after their index episode of acute myocardial infarction (AMI). However, whether women have a higher risk of cardiovascular events in the year after discharge is unknown.MethodsWe used data from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study, which enrolled young AMI patients aged 18 to 55 years across 103 US hospitals. Sex differences in all-cause and cause-specific hospitalizations were compared by calculating incidence rates (IR, per 1,000 person-years) and incidence rate ratios (IRRs) with 95% confidence intervals (CIs). We then performed sequential modeling to evaluate the sex difference by calculating sub-distribution hazard ratios (SHR) accounting for deaths.ResultsAmong 2,007 women and 972 men, at least one all-cause hospitalization occurred among 905 (30.4%) participants in the year after discharge. The leading causes of hospitalization were MI-related (IR 171.8, 95% CI, 153.6-192.2 among women vs. IR 117.8, 95% CI, 97.3-142.6 among men), followed by non-cardiac (IR 145.8, 95% CI, 129.2-164.5 among women vs. IR 69.6, 95% CI, 54.5-88.9 among men) and other cardiac or stroke hospitalizations (IR 58.8, 95% CI, 48.8-70.7 among women vs. IR 53.8, 95% CI, 40.8-71.0 among men). Competing risk analysis showed that the sex difference was present for MI-related hospitalizations (SHR 1.33, 95%CI 1.04-1.70; P=0.02) and non-cardiac hospitalizations (SHR 1.51, 95%CI 1.13-2.07; P=0.01).ConclusionsYoung women with AMI have more adverse outcomes compared with men in the year after discharge. MI-related hospitalizations were the most common cause of hospitalizations, but non-cardiac hospitalizations showed the most significant sex disparity. Further studies to better understand the underlying mechanisms of non-cardiac hospitalizations are warranted.
Publisher
Cold Spring Harbor Laboratory