Abstract 18019: Gender Differences Among Elderly Patients Hospitalized With Acute Coronary Syndrome in the United States Between 2011-2019

Abstract

Introduction: Acute coronary syndrome (ACS) is one of the main causes of morbidity and mortality in the elderly. Women in general are less likely to be referred for coronary catheterization, percutaneous coronary intervention, and fibrinolysis. Hypothesis: We tested the hypothesis that elderly females were less likely to undergo catheterization and revascularization for ACS as compared to elderly men. Methods: We identified hospitalizations for patients aged 75 years old or older admitted with a primary admitting diagnosis of NSTEMI or STEMI between 2016 and 2019 using the National Inpatient Sample Database. Baseline characteristics, in-hospital complications, mortality, and length of stay were compared between male and female patients. A p-value <0.001 was considered significant. Results: We identified a total of 776,485 hospitalizations. See Table 1 for baseline characteristics and in-hospital outcomes. Male patients exhibited a higher prevalence of comorbidities. Furthermore, female patients were more prone to conditions such as hypertension, obesity, dementia, and stroke. In terms of in-hospital complications, male patients had the highest percentage of all complications. Male patients had a statistically significantly higher number of interventions compared to females, including cardiac catheterization (59.7 vs 51.4, p <0.001), percutaneous coronary intervention (39.7 vs 32.8, p <0.001), and CABG (0.8 vs 0.4, p <0.001). Male patients also had the highest length of stay compared to females (4.9 vs 4.6 days, p <0.001). Alternatively, Females were found to have the highest mortality compared to males (7.8 vs 7.5, p <0.001). Conclusions: Our results on ACS outcomes in elderly females are consistent with literature demonstrating that females are less likely to undergo catheterization or revascularization and have higher mortality. More research is needed to address these gender disparities.