PMID- 37092023 OWN - NLM STAT- MEDLINE DCOM- 20230425 LR - 20230425 IS - 2211-8179 (Electronic) IS - 2211-8160 (Print) IS - 2211-8160 (Linking) VI - 18 IP - 1 DP - 2023 TI - Women with Acute Myocardial Infarction: Clinical Characteristics, Treatment, and In-Hospital Outcomes from a Latin American Country. PG - 19 LID - 10.5334/gh.1196 [doi] LID - 19 AB - BACKGROUND: Women are underrepresented in acute myocardial infarction (AMI) studies. Furthermore, there is scarce information regarding women with AMI in Latin America. AIMS: To describe the presentation, clinical characteristics, risk factor burden, evidence-based care, and in-hospital outcome in a population of women with AMI admitted to a coronary care unit (CCU) in Mexico. METHODS: Retrospective cohort study including patients with AMI admitted from January 2006 to December 2021 in a CCU. We identified patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). We described demographic characteristics, clinical variables, treatment, and in-hospital outcomes according to gender. Cox regression analysis was used to identify predictors of mortality. RESULTS: Our study included 12,069 patients with AMI, of whom 7,599 had STEMI and 4,470 had NSTEMI. Women represented 19.6% of the population. Women had higher rates of hypertension, diabetes, stroke, and atrial fibrillation than men. For STEMI, women were less likely to receive reperfusion therapy (fibrinolysis; 23.7 vs. 28.5%, p < 0.001 and primary percutaneous coronary intervention (PCI); 31.2 vs. 35.1%, p = 0.001) and had more major adverse events than men: heart failure (4.2 vs. 2.5%, p = 0.002), pulmonary edema (3.4% vs. 1.7%, p < 0.001), major bleeding (2.1% vs. 1%, p = 0.002), stroke (1.3% vs. 0.6%, p = 0.008), and mortality (15.1% vs. 8.1%, p < 0.001). For NSTEMI, women were less likely to undergo coronary angiography or PCI and had more major bleeding and mortality. Multivariate Cox regression analysis revealed that females had an increase in mortality in STEMI and NSTEMI (HR 1.21, CI 1.01-1.47, p = 0.05 and HR 1.39, CI 1.06-1.81, p = 0.01). CONCLUSION: Real-world evidence from a hospital in a Latin American low- to middle-income country (LMIC) showed that women with AMI had more comorbidities, received less reperfusion treatment or invasive strategies, and had worse outcomes. In STEMI and NSTEMI, female gender represented an independent predictor of in-hospital mortality. CI - Copyright: (c) 2023 The Author(s). FAU - Arias-Mendoza, Alexandra AU - Arias-Mendoza A AUID- ORCID: 0000-0002-5942-4102 AD - Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Gonzalez-Pacheco, Hector AU - Gonzalez-Pacheco H AUID- ORCID: 0000-0002-4370-9963 AD - Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Alvarez-Sangabriel, Amada AU - Alvarez-Sangabriel A AUID- ORCID: 0000-0003-0593-2571 AD - Clinical Cardiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Gopar-Nieto, Rodrigo AU - Gopar-Nieto R AUID- ORCID: 0000-0002-4865-4869 AD - Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Rodriguez-Chavez, Laura Leticia AU - Rodriguez-Chavez LL AUID- ORCID: 0000-0003-1162-9018 AD - Clinical Cardiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Araiza-Garaygordobil, Diego AU - Araiza-Garaygordobil D AUID- ORCID: 0000-0003-3185-0051 AD - Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Ramirez-Rangel, Pamela AU - Ramirez-Rangel P AD - Clinical Cardiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Martinez, Daniel Sierra-Lara AU - Martinez DS AUID- ORCID: 0000-0003-0308-6973 AD - Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Del Carmen Lacy-Niebla, Maria AU - Del Carmen Lacy-Niebla M AUID- ORCID: 0000-0002-4124-8083 AD - Clinical Cardiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Briseno-De la Cruz, Jose Luis AU - Briseno-De la Cruz JL AD - Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Juarez-Tolen, Jessica AU - Juarez-Tolen J AD - Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Mendoza-Garcia, Salvador AU - Mendoza-Garcia S AD - Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Altamirano-Castillo, Alfredo AU - Altamirano-Castillo A AD - Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. LA - eng PT - Editorial DEP - 20230420 PL - England TA - Glob Heart JT - Global heart JID - 101584391 SB - IM MH - Male MH - Humans MH - Female MH - *ST Elevation Myocardial Infarction/epidemiology/therapy MH - *Non-ST Elevated Myocardial Infarction/diagnosis/epidemiology/therapy MH - Latin America/epidemiology MH - *Percutaneous Coronary Intervention MH - Retrospective Studies MH - *Myocardial Infarction/epidemiology/therapy MH - Risk Factors MH - Hemorrhage MH - Hospitals MH - *Stroke MH - Treatment Outcome MH - Registries PMC - PMC10120598 OTO - NOTNLM OT - acute coronary syndromes OT - diagnosis OT - gender differences OT - treatment OT - women COIS- The authors have no competing interests to declare. EDAT- 2023/04/24 06:41 MHDA- 2023/04/25 10:20 PMCR- 2023/04/20 CRDT- 2023/04/24 04:03 PHST- 2022/11/23 00:00 [received] PHST- 2023/03/27 00:00 [accepted] PHST- 2023/04/25 10:20 [medline] PHST- 2023/04/24 06:41 [pubmed] PHST- 2023/04/24 04:03 [entrez] PHST- 2023/04/20 00:00 [pmc-release] AID - 10.5334/gh.1196 [doi] PST - epublish SO - Glob Heart. 2023 Apr 20;18(1):19. doi: 10.5334/gh.1196. eCollection 2023.