Mrinal Kanti Das, Amit Malviya, Geevar Zachariah, Sivasubramanian Ramakrishnan, Abdullakutty Jabir, Venugopal Krishnan Nair, Neil Bardoloi, Dhurjati Prasad Sinha, Partho Sartha Banrjee, S Shanmugasundaram, Gurpreet Singh Wander, Dhiman Kahali, Debabrata Roy, Rakesh Yadav
{"title":"Gender bias in acute myocardial infarction care in India: Nationwide retrospective study of 41832 patients.","authors":"Mrinal Kanti Das, Amit Malviya, Geevar Zachariah, Sivasubramanian Ramakrishnan, Abdullakutty Jabir, Venugopal Krishnan Nair, Neil Bardoloi, Dhurjati Prasad Sinha, Partho Sartha Banrjee, S Shanmugasundaram, Gurpreet Singh Wander, Dhiman Kahali, Debabrata Roy, Rakesh Yadav","doi":"10.1016/j.ihj.2025.01.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Various studies have documented gender differences in the management and outcomes of acute myocardial infarction (AMI) in developed countries. Gender differences in the management of AMI in India is not known.</p><p><strong>Objectives: </strong>To document the gender differences in the management and outcomes of AMI in India.</p><p><strong>Methods: </strong>The current study was a nationwide retrospective, multicenter, cross-sectional study including all consecutive AMI patients admitted from 15th March to 15th June in the year 2020 using a historical control of all cases of AMI admitted during the corresponding period in the year 2019.</p><p><strong>Results: </strong>There were only 9018 females (21.6 %) among the 41832 patients with AMI in the study. Females were older and were more likely to present with non ST-elevation MI than men (41.6 % vs. 33.2 %). Significantly fewer number of females underwent primary percutaneous coronary intervention (29.5 % vs 31.2 % p value < 0.001), thrombolysis (32.9 % vs 34.7 %, p value < 0.001), pharmaco-invasive therapy (18.6 % vs 20.7 % p value 0.001). Females had higher in-hospital mortality (7.07%vs 4.07 %, p < 0.001), length of hospital stay (3.9 ± 2.98 days vs 3.8 ± 2.88 days, p < 0.001) and complications of AMI [cardiogenic shock (8.6 % vs 6.3 %), mechanical complications (4.6 % vs 3.8 %), heart failure (13.9%vs 11.7 %) and malignant arrhythmias (3.4%vs2.8 %)] than males.</p><p><strong>Conclusions: </strong>Differences between gender in the presentation, management, and outcomes of acute MI are prevalent in India. Women with acute MI presented at older age, had higher in-hospital mortality and complications, and received revascularization therapy less often compared to men.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian heart journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.ihj.2025.01.001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Various studies have documented gender differences in the management and outcomes of acute myocardial infarction (AMI) in developed countries. Gender differences in the management of AMI in India is not known.
Objectives: To document the gender differences in the management and outcomes of AMI in India.
Methods: The current study was a nationwide retrospective, multicenter, cross-sectional study including all consecutive AMI patients admitted from 15th March to 15th June in the year 2020 using a historical control of all cases of AMI admitted during the corresponding period in the year 2019.
Results: There were only 9018 females (21.6 %) among the 41832 patients with AMI in the study. Females were older and were more likely to present with non ST-elevation MI than men (41.6 % vs. 33.2 %). Significantly fewer number of females underwent primary percutaneous coronary intervention (29.5 % vs 31.2 % p value < 0.001), thrombolysis (32.9 % vs 34.7 %, p value < 0.001), pharmaco-invasive therapy (18.6 % vs 20.7 % p value 0.001). Females had higher in-hospital mortality (7.07%vs 4.07 %, p < 0.001), length of hospital stay (3.9 ± 2.98 days vs 3.8 ± 2.88 days, p < 0.001) and complications of AMI [cardiogenic shock (8.6 % vs 6.3 %), mechanical complications (4.6 % vs 3.8 %), heart failure (13.9%vs 11.7 %) and malignant arrhythmias (3.4%vs2.8 %)] than males.
Conclusions: Differences between gender in the presentation, management, and outcomes of acute MI are prevalent in India. Women with acute MI presented at older age, had higher in-hospital mortality and complications, and received revascularization therapy less often compared to men.
背景:各种研究已经记录了发达国家急性心肌梗死(AMI)治疗和结局的性别差异。印度急性心肌梗死管理中的性别差异尚不清楚。目的:记录印度急性心肌梗死治疗和预后的性别差异。方法:本研究是一项全国回顾性、多中心、横断面研究,包括2020年3月15日至6月15日住院的所有连续AMI患者,并以2019年同期入院的所有AMI病例为历史对照。结果:41832例AMI患者中,女性仅9018例(21.6%)。女性年龄较大,比男性更容易出现非st段抬高型心肌梗死(41.6%比33.2%)。接受初级经皮冠状动脉介入治疗的女性人数明显减少(29.5% vs 31.2% p值)。结论:在印度,急性心肌梗死的表现、治疗和结局存在性别差异。女性急性心肌梗死发病年龄较大,住院死亡率和并发症较高,与男性相比,接受血运重建治疗的频率较低。
期刊介绍:
Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.