Abstract 3123: Sex Disparities In In-hospital Outcomes After Percutaneous Coronary Intervention In Patients With Acute Myocardial Infarction And A History Of Coronary Artery Bypass Grafting: A Nationwide Inpatient Sample-matched Analysis (2016-2019)

Abstract

Background: The role of sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in patients with a history of coronary artery bypass grafting (CABG) remains underexplored. This study aimed to identify sex disparities in in-hospital outcomes after PCI in patients with AMI and a history of CABG. Methods: Using the National Inpatient Sample database, we identified patients hospitalized for AMI with a history of CABG who underwent PCI between 2016 and 2019. Outcomes were compared between male and female patients using multiple logistic regression and 1:1 propensity score matching. The relationship between age and in-hospital mortality among male and female patients was explored using smooth curve fitting and subgroup analysis. Results: In total, 75,185 weighted hospitalizations of patients who underwent PCI were identified, with 25.2% being female patients. Compared with male patients, female patients had a higher burden of Elixhauser comorbidities (comorbidity index >4; 33.10% vs. 27.11%, P <0.001). Regarding in-hospital outcomes, female patients exhibited elevated risk of in-hospital mortality (3.72% vs. 2.85%, P =0.0095). After propensity score matching, female patients still had higher in-hospital mortality rates than did male patients (3.8% vs. 2.8%, P =0.019). Multivariable logistic regression (adjusted odds ratio [aOR]: 1.48; 95% confidence interval [CI]: 1.14-1.92) and propensity score matching (aOR: 1.50; 95% CI: 1.08-2.09) showed a consistently higher risk of in-hospital mortality among female patients than among male patients. There was an upward trend in in-hospital mortality across all age categories, with a steeper increase in patients aged >60 years. Female patients aged >60 years were more vulnerable to in-hospital mortality than were their male counterparts (3.06% vs. 4.15%, P =0.0003, aOR: 1.55; 95% CI: 1.18-2.04). Conclusions: Female patients who underwent PCI for AMI with a history of CABG had a higher in-hospital mortality rate, which was particularly evident among older patients aged >60 years. Therefore, sex- and age-specific investigations and interventions are required to reduce disparities within this high-risk population.