Women at higher risk for HF hospitalization after acute MI vs. men
Female patients had higher risk for HF hospitalization after survival of acute MI compared with male patients, according to study findings published in Heart.
“HF is a frequent complication of acute MI. ... In patients with acute MI, the presence of HF, either on presentation or during the index hospitalization, is a poor prognostic marker and associated with a threefold to sixfold increase in mortality,” Srikanth Yandrapalli, MD, cardiology fellow at Westchester Medical Center, New York Medical College, and colleagues wrote. “Although coronary heart disease and MI are less prevalent among females than males, females are more likely to have in-hospital HF and death complications from acute MI.”
In a retrospective cohort analysis, researchers analyzed 237,549 patients (38% women; mean age, 67 years) who survived acute MI. The outcome of interest was HF hospitalization within 6 months after initial hospital discharge. Secondary outcomes included fatal HF hospitalization and composite of index in-hospital HF or 6-month HF hospitalization.
According to the researchers, 5.4% of patients underwent HF hospitalization, with HF occurring at a 49% higher rate in female patients compared with male patients (6.8% vs. 4.6%; P < .001). In a further propensity-matched analysis, female sex was tied to a 13% higher risk for 6-month HF hospitalization (6.4% vs. 5.8%; HR = 1.13, 95% CI, 1.05-1.21; P < .001) and a 32% higher rate of the composite outcome of HF during the index admission or a 6-month readmission of HF (36.2% vs. 27.5%; P < .001). Researchers noted similar fatality rates between female patients and male patients (4.7% vs. 4.6%, P = .936).
“Female acute MI survivors had higher rates of HF readmission ... compared with their male counterparts. Although this sex difference was partly explained by the lower revascularization rate and greater risk factor burden in females at the time of acute MI presentation, females had a higher HF hospitalization risk even after extensive adjustment for those baseline differences,” Yandrapalli and colleagues wrote. “These findings suggest a crucial need to understand the underlying factors responsible for the observed sex differences in HF outcomes after an acute MI in an effort to mitigate the development of this complication and associated health care implications.”