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Women at Increased Risk for Heart Failure, Death After MI

TUESDAY, Dec. 1, 2020 -- Women are at increased risk for heart failure and death after first-time myocardial infarction (MI), according to a study published online Nov. 30 in Circulation.

Justin A. Ezekowitz, M.B.B.Ch., from the University of Alberta in Edmonton, Canada, and colleagues examined the incidence, angiographic findings, treatment, and clinical outcomes of 45,064 patients (30.8 percent women) hospitalized with a primary diagnosis of first-time MI between 2002 and 2016 (54.9 percent non-ST-segment elevation MI [NSTEMI] and 45.1 percent ST-segment elevation MI [STEMI]).

The researchers found that compared with men, women were older, had more comorbidities, and had lower rates of diagnostic angiography. Among patients with STEMI and NSTEMI, women had a higher unadjusted rate of in-hospital mortality than men (STEMI, 9.4 versus 4.5 percent; NSTEMI, 4.7 versus 2.9 percent). The difference remained significant after adjustment in STEMI patients (adjusted odds ratio, 1.42; 95 percent confidence interval, 1.24 to 1.64) but not in NSTEMI patients (adjusted odds ratio, 0.97; 95 percent confidence interval, 0.83 to 1.13). After discharge more women than men developed heart failure after STEMI (22.5 versus 14.9 percent) and NSTEMI (23.2 versus 15.7 percent). Across the years, these differences remained similar.

"There are gaps across diagnosis, access, quality of care, and follow-up for all patients, so we need to be vigilant, pay attention to our own biases and to those most vulnerable to ensure that we have done everything possible in providing the best treatment," a coauthor said in a statement.

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Posted: December 2020