Markson Favour E, Allihien Saint-Martin, Antia Akanimo, Kesiena Onoriode, Kwaku Kevin F
Department of Medicine, Lincoln Medical Center, Bronx, New York, USA.
Department of Internal Medicine, Piedmont Athens regional Medical Center, Atlanta, Georgia, USA.
JACC Adv. 2024 Jul 3;3(7):101042. doi: 10.1016/j.jacadv.2024.101042. eCollection 2024 Jul.
Ventricular arrhythmias (VAs) are a common cause of death in patients with acute myocardial infarction (AMI). Studies have shown sex differences in the incidence, presentation, and outcomes of AMI. However, less is known about sex differences in patients with AMI who develop VAs.
The authors assessed sex differences in incidence and in-hospital outcomes of patients with AMI and VAs.
Using the National Inpatient Sample 2016 to 2020, we conducted a retrospective analysis of patients admitted for AMI with a secondary diagnosis of VAs. Multivariable logistic regression was performed to estimate the sex-specific differences in the rates and in-hospital outcomes of VAs post-AMI.
We identified 1,543,140 patients admitted with AMI. Of these, (11.3%) 174,565 patients had VAs after AMI. The odds of VAs after AMI were higher among men (12.6% vs 8.8% adjusted odds ratio [AOR]: 1.72; CI: 1.67-1.78; < 0.001). Women had significantly higher odds of in-hospital mortality (AOR: 1.32; CI: 1.21-1.42; < 0.001), cardiogenic shock (AOR: 1.08; CI: 1.01-1.15; < 0.022), and cardiac arrest (AOR: 1.11; CI: 1.03-1.18; < 0.002). Women were less likely to receive an implantable cardioverter-defibrillator (ICD) (AOR: 0.57; CI: 0.47-0.68; < 0.001) or undergo catheter ablation (AOR: 0.51; CI: 0.27-0.98; < 0.001) during the index admission.
We found important sex differences in the incidence and outcomes of VAs among patients with AMI. Women had lower odds of VAs but worse hospital outcomes overall. In addition, women were less likely to receive ICD. Further studies to address these sex disparities are needed.
室性心律失常（VAs）是急性心肌梗死（AMI）患者常见的死亡原因。研究表明，AMI的发病率、表现和预后存在性别差异。然而，对于发生VAs的AMI患者的性别差异了解较少。
作者评估了AMI合并VAs患者的发病率和院内结局的性别差异。
利用2016年至2020年的全国住院患者样本，我们对因AMI入院且二级诊断为VAs的患者进行了回顾性分析。进行多变量逻辑回归以估计AMI后VAs发生率和院内结局的性别特异性差异。
我们确定了1543140例因AMI入院的患者。其中，174565例（11.3%）患者在AMI后发生了VAs。AMI后发生VAs的几率在男性中更高（12.6%对8.8%，调整优势比[AOR]：1.72；CI：1.67 - 1.78；<0.001）。女性的院内死亡率（AOR：1.32；CI：1.21 - 1.42；<0.001）、心源性休克（AOR：1.08；CI：1.01 - 1.15；<0.022）和心脏骤停（AOR：1.11；CI：1.03 - 1.18；<0.002）的几率显著更高。女性在首次住院期间接受植入式心脏复律除颤器（ICD）（AOR：0.57；CI：0.47 - 0.68；<0.001）或进行导管消融（AOR：0.51；CI：0.27 - 0.98；<0.001）的可能性较小。
我们发现AMI患者中VAs的发病率和结局存在重要的性别差异。女性发生VAs的几率较低，但总体住院结局较差。此外，女性接受ICD的可能性较小。需要进一步研究以解决这些性别差异问题。
