Blog | Tuesday, July 22, 2014

QD: News Every Day--Young women with heart attacks face more mortality, longer hospital stays

Young women with heart attacks have more comorbidity, longer hospital stays, and higher in-hospital mortality than young men, although their mortality rates are decreasing, a study found.

To determine sex differences in clinical characteristics, hospitalization rates, length of stay, and in-hospital mortality by age group and race among young patients with acute myocardial infarctions (AMIs), researchers applied data from the National Inpatient Sample for patients with AMI across ages 30 to 54 years, dividing them into 5-year subgroups from 2001 to 2010.

Results appeared in the Journal of the American College of Cardiology.

There were more than 230,000 hospitalizations with a principal discharge diagnoses of AMI in 30- to 54-year-old patients, or nearly 1.13 million hospitalizations. Women were nearly 26% of young patients hospitalized with AMI. There were no statistically significant declines in AMI hospitalization rates age groups younger than 55 years old, or when stratified by sex.

Hospitalization rates for AMI were higher in men compared with women across all age subgroups. The absolute number of discharges for AMI among women increased from 56 per 100,000 in 2001 to 61 per 100,000 in 2010. But, the absolute number of discharges for AMI among men decreased from 174 per 100,000 to 171 per 100,000. Although absolute declines were noted for most subgroups of men, women showed either no change (30 to 34 and 35 to 39 years of age) or a slight absolute increase (40 to 44 and 45 to 49 years of age) in hospitalization rates.

Women had higher in-hospital mortality than men across all subgroups. From 2001 to 2010, overall observed in-hospital mortality for women with AMIs declined from 3.3% to 2.3%, (a 30.6% decrease; P for trend<0.0001). For men, the decrease for men was from 2% to 1.8%, (an 8.5% decrease; P for trend=0.6).

Authors noted that the results suggest a greater need for intensive primary prevention efforts in the high-risk young population, and that young women may gain more benefit from aggressive control of cardiovascular risk factors such as hypertension, hyperlipidemia, obesity, smoking, and diabetes.

An editorial stated that persistent excess mortality among young women emphasizes the ineffectiveness of current practices and the need for sex-specific research and guideline development. “It remains vital that sex-specific differences in guidelines constitute more than 1 page of our large guideline documents.”