Daily Dose: Sex Difference in Outcomes of AMI in Young Adults

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On May 3, 2023, we reported on a study published in the Journal of the American College of Cardiology that aimed to determine sex differences in causes and timing of 1-year outcomes after acute myocardial infarction (AMI) in persons aged 18-55 years.

The study

Investigators analyzed data from 2979 participants (2007 women, 972 men) from the VIRGO study, which enrolled young adults with AMI across 103 US hospitals. Researchers assessed sex differences in all-cause and cause-specific hospitalizations by calculating incidence rates ([IRs] per 1000 person-years) and IR ratios (IRR).

The findings

The leading causes of hospitalization were coronary related for both sexes but incidence rates for women were higher than for men (IR 171.8, 95% CI 153.6-192.2 among women vs 117.8, 95% CI 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).

Investigators also observed sex-based differences for coronary-related hospitalizations (subdistribution HR [SHR] 1.33, 95% CI 1.04-1.70; P=.02) and noncardiac hospitalizations (SHR 1.51, 95% CI 1.13-2.07; P=.01).

Note from authors

"Young women with AMI have persistently worse outcomes compared with men immediately and 1 year after discharge. Coronary-related hospitalizations were the most common cause of hospitalizations, but noncardiac hospitalizations showed the greatest sex disparity among young patients after AMI. Further studies to better understand the underlying mechanisms of noncardiac hospitalizations are warranted."

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