Abstract 207: Gender Differences in Pre-Event Health Status of Young Patients with Acute Myocardial Infarction: Insights from the VIRGO Study

Abstract

Background: Young women have a worse prognosis following acute myocardial infarction (AMI) then young men. Health status (symptoms, functioning and quality of life) prior to an AMI has received little attention and the pre-existing health status of young women presenting with an AMI, as compared with men, is unknown. Methods: VIRGO is a prospective observational study that enrolled 3,501 AMI patients (67% women) aged ≤55 years from the US and Spain. Clinical information was abstracted from medical records and health status data was collected through interviews at the time of the AMI [the Short Form 12 (SF-12), the EuroQol (EQ-5D) and the Seattle Angina Questionnaire (SAQ)]. To compare women and men, we used t-test/chi-square analyses and multivariable linear/logistic regression analysis, sequentially adjusting for socio-demographic, and co-morbidities, to identify clinical factors associated with patients’ health status. Results: Women were more likely to present with diabetes (39% vs. 27%), obesity (51% vs. 45%), stroke (5% vs. 2%), renal dysfunction (12% vs. 8%), lung disease (13% vs. 5%) and depression (48% vs. 24%; P<0.0001 for all). Prior to the event, women reported significantly worse general health scores (SF-12 physical summary score= 43±12 vs. 46±11, mental summary score= 44±13 vs. 48±11 and EQ-5D visual analog scale= 63±22 vs. 67±20, p<0.001 for all), more angina (SAQ angina frequency=83±22 vs. 87±18, p<0.001), poorer physical function (SAQ physical limitation=78±27 vs. 87±21, p<0.0001) and worse quality of life (SAQ QoL= 55±25 vs. 60±22, P<0.0001). Following adjustment for clinical covariates, female gender was independently associated with an increased odds of having more physical limitations due to angina (SAQ PL: OR=1.29, 95% CI 1.09,1.53, P=0.0025) poorer quality of life (SAQ QOL: β=-3.19; SE=0.89, P=0.0004); worse physical (SF-12: -1.04; 0.42, P=0.0136) and mental function (SF-12: -2.07; 0.46, P<0.0001). Conclusion: Young women with an AMI have poorer health status prior to their event than men. This suggests worse symptom control prior to an AMI and underscores the need to adjust for baseline health status in evaluations of gender-based disparities in young AMI patients.