Abstract 2129: Gender Based Disparities In Outcomes, Resource Utilization & Readmission Rates In St-Elevation Myocardial Infarction

Abstract

Background: Cardiovascular disease is the leading cause of death among women; however acute coronary events tend to be under-managed in females due to higher atypical presentation & delay in diagnosis. We aim to investigate gender disparities in ST-elevation myocardial infarction (STEMI) outcomes. Methods: The national readmission database (2016-2020) was queried to identify hospitalizations for STEMI. Cohorts were stratified based on males and females admitted with STEMI. A Propensity Score Matching (PSM) model matched males and females with STEMI. Pearson’s x 2 test was applied to PSM-2 matched cohorts to compare outcomes. Results: Among 1 million hospitalizations for STEMI, 332,165 (31.86%) were females. After propensity matching (N=176,688), females had higher inpatient mortality (14.7% vs 14.5%, aOR: 1.13), CVA (3.3% s 2.7%; aOR 1.25), vascular complications (0.9% vs 0.3%; aOR 1.58%) and transfusion requirement (5.8% vs 5.2%, aOR:1.19) [p<0.05]. Females were less likely to receive a PCI (63.1% vs 65.8%, aOR: 0.83) or undergo an emergent CABG (0.8% vs 1.1%, aOR: 0.72) [p<0.001] for acute STEMI. From 2016-2020; STEMI related mortality has decreased from 12.7% to 12.4% in females (p-trend:0.047) while utilization of PCI has increased from 58.2 to 66.2 (p-trend<0.05). Furthermore, female patients had higher readmission rates on 30-day (10.8% vs. 10.2%), 90-day & 180-day intervals (p<0.001). Conclusion: In STEMI patients, female patients had higher mortality, cardiovascular complications & readmission rates. They less frequently underwent cardiac interventions than males. However, utilization of PCI is increasing, and associated mortality is decreasing.