Abstract 12701: Sex Differences in Characteristics, Treatments, and Outcomes Among Patients With ST-Segment Elevation Myocardial Infarction from 2001 to 2011: Insights From the China PEACE-Retrospective Study
Introduction: Studies in the U.S. and Europe suggest important sex differences in the care and outcomes of acute myocardial infarction (AMI). Little is known about sex-based differences in characteristics, treatments, and outcomes of patients with AMI in China, a country in which cardiovascular disease in women is just emerging.
Methods: We evaluated a nationally representative sample of 11,986 patients with ST-segment elevation myocardial infarction (STEMI) admitted to 162 randomly sampled Chinese hospitals in 2001, 2006, and 2011.
Results: Over time, the proportion of women remained relatively unchanged (30% in 2011). Compared with men, women were older (median age 71 vs. 63 years, P<0.001), had a higher frequency of co-morbidities (Figure 1), and had longer time delays from symptom onset to admission (>12h: 53.2% vs. 48.7%, P<0.001). Among eligible patients, fewer women received evidence-based therapies than men, including reperfusion therapy (44.2% vs. 57.5%, P<0.001) (Figure 2), early aspirin (85.9% vs. 88.8%, P<0.001), and clopidogrel (52.5% vs. 56.9%,P<0.001). The unadjusted in-hospital mortality was higher among women (17.2% vs. 9.1%, P<0.001) and remained significantly elevated following multivariable adjustment (OR=1.33, 95% CI: 1.14 to 1.54). The sex differences in patient characteristics, treatments, and mortality were largely unchanged between 2001 and 2011.
Conclusions: Among Chinese patients with STEMI, women had a higher burden of cardiovascular risk factors, received lower quality of care, and had a higher mortality. There was no evidence that these differences diminished over the last decade.
Author Disclosures: X. Du: None. E.S. Spatz: None. R.P. Dreyer: None. S. Hu: None. X. Li: None. J. Li: None. S. Wang: None. K. Nasir: None. J.A. Spertus: None. F.A. Masoudi: None. H.M. Krumholz: Research Grant; Significant; Medtronic, Johnson and Johnson. Consultant/Advisory Board; Significant; United Health Care. L. Jiang: None.
- © 2014 by American Heart Association, Inc.