Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 3;3(7):101042.
doi: 10.1016/j.jacadv.2024.101042. eCollection 2024 Jul.

Sex Differences in Ventricular Arrhythmias and Adverse Outcomes Following Acute Myocardial Infarction

Favour E Markson  1 , Saint-Martin Allihien  2 , Akanimo Antia  1 , Onoriode Kesiena  2 , Kevin F Kwaku  3
Affiliations

Sex Differences in Ventricular Arrhythmias and Adverse Outcomes Following Acute Myocardial Infarction

Favour E Markson et al. JACC Adv. .

Abstract

Background: Ventricular arrhythmias (VAs) are a common cause of death in patients with acute myocardial infarction (AMI). Studies have shown sex differences in the incidence, presentation, and outcomes of AMI. However, less is known about sex differences in patients with AMI who develop VAs.

Objectives: The authors assessed sex differences in incidence and in-hospital outcomes of patients with AMI and VAs.

Methods: Using the National Inpatient Sample 2016 to 2020, we conducted a retrospective analysis of patients admitted for AMI with a secondary diagnosis of VAs. Multivariable logistic regression was performed to estimate the sex-specific differences in the rates and in-hospital outcomes of VAs post-AMI.

Results: We identified 1,543,140 patients admitted with AMI. Of these, (11.3%) 174,565 patients had VAs after AMI. The odds of VAs after AMI were higher among men (12.6% vs 8.8% adjusted odds ratio [AOR]: 1.72; CI: 1.67-1.78; P < 0.001). Women had significantly higher odds of in-hospital mortality (AOR: 1.32; CI: 1.21-1.42; P < 0.001), cardiogenic shock (AOR: 1.08; CI: 1.01-1.15; P < 0.022), and cardiac arrest (AOR: 1.11; CI: 1.03-1.18; P < 0.002). Women were less likely to receive an implantable cardioverter-defibrillator (ICD) (AOR: 0.57; CI: 0.47-0.68; P < 0.001) or undergo catheter ablation (AOR: 0.51; CI: 0.27-0.98; P < 0.001) during the index admission.

Conclusions: We found important sex differences in the incidence and outcomes of VAs among patients with AMI. Women had lower odds of VAs but worse hospital outcomes overall. In addition, women were less likely to receive ICD. Further studies to address these sex disparities are needed.

Keywords: acute myocardial infarction; sex or gender disparities; ventricular arrhythmias.

PubMed Disclaimer

Conflict of interest statement

Dr Kwaku has received consulting services to AltaThera, Anthos Therapeutics, Biosense Webster, and Janssen Scientific Affairs; travel support from Medtronic; and contracted research support from Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Flow Chart of Our Study Population The flow chart displays the selection of patients with acute myocardial infarction and ventricular arrhythmias (ventricular tachycardia and ventricular fibrillation) from year January 1, 2016, to December 31, 2020. AMI = acute myocardial infarction.
Figure 2
Figure 2
Sex Differences in the In-Hospital Outcomes of Patients With AMI Complicated by Ventricular Arrhythmias The Forest plot shows the in-hospital outcomes of ventricular arrhythmias in women compared to men, represented with adjusted ORs and their 95% CIs. AMI = acute myocardial infarction; ICD = implantable cardioverter-defibrillator.
Central Illustration
Central Illustration
Major Sex Differences in Demography and Clinical Outcomes of Patients With Acute Myocardial Infarction and VentricularArrhythmias ICD = implantable cardioverter-defibrillator; MI = myocardial infarction.
See this image and copyright information in PMC

References

    1. Bhar-Amato J. Ventricular arrhythmia after acute myocardial infarction: ‘the Perfect Storm’. 2017. https://www.aerjournal.com/articles/ventricular-arrhythmia-after-acute-m... - PMC - PubMed
    1. Piccini J.P., Berger J.S., Brown D.L. Early sustained ventricular arrhythmias complicating acute myocardial infarction. Am J Med. 2008;121(9):797–804. doi: 10.1016/j.amjmed.2008.04.024. - DOI - PubMed
    1. Masuda M., Nakatani D., Hikoso S., et al. Clinical impact of ventricular tachycardia and/or fibrillation during the acute phase of acute myocardial infarction on in-hospital and 5-year mortality rates in the percutaneous coronary intervention era. Circ J. 2016;80(7):1539–1547. doi: 10.1253/circj.CJ-16-0183. - DOI - PubMed
    1. Thomas D.E., Jex N., Thornley A.R. Ventricular arrhythmias in acute coronary syndromes—mechanisms and management. Contin Cardiol Educ. 2017;3(1):22–29. doi: 10.1002/cce2.51. - DOI
    1. Hersi A.S., Alhabib K.F., AlFaleh H.F., et al. Incidence of ventricular arrhythmia and associated patient outcomes in hospitalized acute coronary syndrome patients in Saudi Arabia: findings from the Registry of the Saudi Project for Assessment of Acute Coronary Syndrome (SPACE) Ann Saudi Med. 2012;32(4):372–377. doi: 10.5144/0256-4947.2012.372. - DOI - PMC - PubMed

LinkOut - more resources