Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients

BACKGROUND Younger women experience worse health status than men after their index episode of acute myocardial infarction (AMI). However, whether women have a higher risk for cardiovascular and noncardiovascular hospitalizations in the year after discharge is unknown. OBJECTIVES The aim of this study was to determine sex differences in causes and timing of 1-year outcomes after AMI in people aged 18 to 55 years.METHODS Data from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study, which enrolled young patients with AMI across 103 U.S. hospitals, were used. Sex differences in all-cause and cause-specific hospitalizations were compared by calculating incidence rates ([IRs] per 1,000 person-years) and IR ratios with 95% CIs. We then performed sequential modeling to evaluate the sex difference by calculating subdistribution HRs (SHRs) accounting for deaths.RESULTS Among 2,979 patients, at least 1 hospitalization occurred among 905 patients (30.4%) in the year after discharge. The leading causes of hospitalization were coronary related (IR: 171.8 [95% CI: 153.6-192.2] among women vs 117.8 [95% CI: 97.3-142.6] among men), followed by noncardiac hospitalization (IR: 145.8 [95% CI: 129.2-164.5] among women vs 69.6 [95% CI: 54.5-88.9] among men). Furthermore, a sex difference was present for coronary-related hospi-talizations (SHR: 1.33; 95% CI: 1.04-1.70; P = 0.02) and noncardiac hospitalizations (SHR: 1.51; 95% CI: 1.13-2.07; P = 0.01).CONCLUSIONS Young women with AMI experience more adverse outcomes than men in the year after discharge. Coronary-related hospitalizations were most common, but noncardiac hospitalizations showed the most significant sex disparity. (J Am Coll Cardiol 2023;81:1797-1806) (c) 2023 by the American College of Cardiology Foundation.

Automated summary

Younger women have poorer health outcomes than men after experiencing acute myocardial infarction (AMI), and it is unknown whether they have a higher risk for cardiovascular and noncardiovascular hospitalizations in the year after discharge. This study aimed to determine sex differences in causes and timing of 1-year outcomes after AMI in people aged 18 to 55 years. Analysis of data showed that young women with AMI had a higher rate of hospitalization in the year after discharge, with a sex disparity in both coronary-related and noncardiac hospitalizations.