Sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and a history of coronary artery bypass grafting (CABG): 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. The primary outcome was in--hospital mortality, and the secondary outcomes were the length of hospital stay and hospitalization costs. 1:1 propensity score matching was used to minimize standardized mean differences of baseline variables and compare in--hospital outcomes.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 exhibited elevated risks of in-hospital mortality (3.72% vs. 2.85%, p = 0.0095), longer length of stay (4.64 days vs. 3.96 days, p < 0.001), and higher hospitalization costs ($112,594.43 vs. $107,020.54, p = 0.0019). After propensity score matching, female patients had higher in-hospital mortality rates than male patients (3.81% vs. 2.89%, p = 0.028). Multivariable logistic regression (adjusted odds ratio [aOR]: 1.48; 95% confidence interval [CI]: 1.14–1.92) and propensity score matching (aOR: 1.34; 95% CI: 1.03–1.73) showed a consistently higher risk of in-hospital mortality among female patients than among male patients. 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..
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Preprint| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
bioRxiv.org - (2024) vom: 16. März Zur Gesamtaufnahme - year:2024 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yan, Rui [VerfasserIn] |
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Volltext [kostenfrei] |
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| doi: |
10.1101/2024.03.11.24304146 |
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| PPN (Katalog-ID): |
XBI042916933 |
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| 245 | 1 | 0 | |a Sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and a history of coronary artery bypass grafting (CABG): A nationwide inpatient sample-matched analysis (2016–2019) |
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| 520 | |a 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. The primary outcome was in--hospital mortality, and the secondary outcomes were the length of hospital stay and hospitalization costs. 1:1 propensity score matching was used to minimize standardized mean differences of baseline variables and compare in--hospital outcomes.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 exhibited elevated risks of in-hospital mortality (3.72% vs. 2.85%, p = 0.0095), longer length of stay (4.64 days vs. 3.96 days, p < 0.001), and higher hospitalization costs ($112,594.43 vs. $107,020.54, p = 0.0019). After propensity score matching, female patients had higher in-hospital mortality rates than male patients (3.81% vs. 2.89%, p = 0.028). Multivariable logistic regression (adjusted odds ratio [aOR]: 1.48; 95% confidence interval [CI]: 1.14–1.92) and propensity score matching (aOR: 1.34; 95% CI: 1.03–1.73) showed a consistently higher risk of in-hospital mortality among female patients than among male patients. 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. | ||
| 650 | 4 | |a Biology |7 (dpeaa)DE-84 | |
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| 700 | 1 | |a Ma, Xueping |4 aut | |
| 700 | 1 | |a Shi, Bo |4 aut | |
| 700 | 1 | |a Ye, Congyan |4 aut | |
| 700 | 1 | |a Fu, Shizhe |4 aut | |
| 700 | 1 | |a Wang, Kairu |4 aut | |
| 700 | 1 | |a Qi, Haohong |4 aut | |
| 700 | 1 | |a Cui, Mingzhi |4 aut | |
| 700 | 1 | |a Yan, Ru |4 aut | |
| 700 | 1 | |a Jia, Shaobin |4 aut | |
| 700 | 1 | |a Cong, Guangzhi |0 (orcid)0000-0002-0174-5026 |4 aut | |
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