440 An Analysis on Gender Disparities in a Contemporary Acute Myocardial Infarction (AMI) Cohort

Abstract

Gender disparities exist in AMI presentation, management and outcomes, with studies indicating that young AMI females have increased clinical risk, and are less aggressively managed. We examined outcomes in young (<60yrs) and intermediate (60-69yrs) AMI patients and compared risk profiles, management and clinical outcomes by gender to examine possible disparities in our clinical practice. Patients were selected from our Wellington Hospital AMI registry who met the following criteria: confirmed AMI via angiography, under 69 years of age, and 5yr outcome data available. Demographics, clinical characteristics and whether revascularisation occurred were collected from patient records. Rates of death and recurrent AMI were noted from electronic national records. We identified 359 patients under 60 years (77% males, 23% females), and 314 patients in the 60-69 range (73% male, 27% female). Risk profiles (defined by GRACE scores) did not differ by gender in either age range. The proportion of NSTEMI/STEMI showed no gender difference in either age group. Rates of revascularisation were significantly lower in female patients under 60 (58% vs 83%, p<0.0001), and in females aged 60-69 (65% vs 81%, p<0.01). Gender was not found to be associated with differences in 5yr death/AMI rates in either age group. We did not identify gender disparities in the risk profiles of young or intermediate age AMI patients. However, in both groups rates of revascularisation were significantly lower in females. It is unclear what is driving this disparity, or the clinical significance given that long term outcomes showed no gender disparity.