Study on AMI Readmission Risks in Women Over 55

According to a recent study, women over the age of 55 who have survived an acute myocardial infarction (AMI) may have nearly twice the chance of being readmitted in the year after discharge compared to males their age.

The most common reasons for hospital readmission did not differ by sex in an analysis of data from the prospective Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study; however, young women consistently had higher risks of all-cause, coronary-related, and noncardiac rehospitalizations than did men.

The National Heart, Lung, and Blood Institute, a division of the National Institutes of Health (NIH), provided funding for the research, which was then published online on May 1, 2023, in the Journal of the American College of Cardiology.

For the first time, it has been shown that some non-cardiac variables, such as depression and poor income, are related with worse outcomes and are followed by rehospitalizations after heart attacks in women aged 55 and younger. The research suggests that, in order to assist in developing better therapeutic treatments and enhance outcomes after discharge for a heart attack, more attention has to be paid to these noncardiac risk factors in younger women.

Krumholz and colleagues examined data from 2979 individuals (2007 women, 972 men) from the VIRGO trial, which recruited young adults with acute MI across 103 US hospitals, to evaluate sex differences in causes and timing of 1-year outcomes following AMI in people aged 18 to 55. Researchers used incidence rates ([IRs] per 1000 person-years) and IR ratios (IRR) to analyze sex disparities in hospitalizations for all causes and cause-specific conditions.

Findings

The cohort's mean age was 47.1 years, and 905 patients (30.4%) had at least one hospitalization in the year after release.

• Both sexes experienced coronary-related hospitalization as the leading cause of admission, but incidence rates for women were higher than those for men (IR 171.8, 95% CI 153.6-192.2 among women vs 117.8, 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).
• Researchers found sex-based differences for hospitalizations associated with coronary disease (subdistribution HR [SHR] 1.33, 95% CI 1.04-1.70; P=.02) and noncardiac disease (SHR 1.51, 95% CI 1.13-2.07; P=.01).

It is necessary to do further research to comprehend the underlying processes of noncardiac hospitalizations.

Reference

Krumholz HM, Sawano M, Lu Y, et al. Sex difference in outcomes of acute myocardial infarction in young patients. JACC. 2023;18:1797-1806.