Abstract 16042: Sex/Gender Specific Differences in the Outcomes of Ventricular Arrhythmias Complicating Acute Myocardial Infarction

Abstract

Introduction: Ventricular Arrythmias (VA) is a common clinical problem in myocardial ischemia and the most common cause of sudden death in patients with Acute Myocardial Infarction (AMI). Studies have shown sex differences in the incidence, presentation, and outcomes of AMI. However, evidence on the sex differences in VA in patients with AMI is limited. In this study we evaluated the sex differences in the incidence and in- hospital outcomes of VA in patients who were admitted with AMI. Methods: Using the NIS 2016 - 2020, we retrospectively analyzed the data of patients admitted for AMI using the ICD 10 code (I21). Our primary population included patients who underwent reperfusion (PCI or CABG), 18 years and above, and had a secondary diagnosis of either Ventricular Fibrillation (VF) or Ventricular Tachycardia (VT). We excluded patients who had infiltrative cardiac diseases (Sarcoidosis, Lyme disease, amyloidosis) or long QT syndrome. We further divided our sample population into 2 groups based on their reported gender (Male or Female). Using a multivariate analysis, we compared the odds of VA and in-hospital outcomes between both subgroups of patients. Results: We identified 174,565 patients with VA in the setting of AMI. Of these 75.8% were males. VF was observed in 15,500 (36.4%) of female patients and 45,010 (34%) of male patients. The odds of VA after AMI were higher in Men (AOR): 1.72, CI: 1.67 - 1.78, p<0.001). Male patients were more likely to have a history of myocardial infarction, smoking and Cocaine use while female patients were more likely to have DM, PVD and heart failure. Female patients had significantly higher odds of in-hospital mortality (AOR: 1.32, CI: 1.21 - 1.42, p<0.001), cardiogenic shock (AOR: 1.08, CI: 1.01 - 1.15, p<0.022) and Cardiac arrest (AOR:1.11, CI: 1.03 - 1.18, p<0.002). However, they had significantly lower odds of defibrillator insertion (AOR: 0.57, CI: 0.47 - 0.68, p<0.001) or catheter ablation (AOR: 0.51, CI: 0.27 - 0.98, p<0.001) during the index admission. Conclusion: There are sex differences in the incidence and outcomes of VA in AMI, with women having lower odds of VA but worse hospital outcomes. Incorporation of women in more VA studies and may help us understand why these differences in outcomes exists