Young Hispanic Women Experience Higher In-Hospital Mortality Following an Acute Myocardial Infarction.
BACKGROUND
Although mortality rates for acute myocardial infarction (AMI) have declined for men and women, prior studies have reported a sex gap in mortality such that younger women were most likely to die after an AMI.


RESULTS
We sought to explore the impact of race and ethnicity on the sex gap in AMI patterns of care and mortality for younger women in a contemporary patient cohort. We constructed multivariable hierarchical logistic regression models to examine trends in AMI hospitalizations, procedures, and in-hospital mortality by sex, age (<65 and ≥65 years), and race/ethnicity (white, black, and Hispanic). Analyses were derived from 194 071 patients who were hospitalized for an AMI with available race and ethnicity data from the 2009-2010 National Inpatient Sample. Hospitalization rates, procedures (coronary angiography, percutaneous coronary interventions, and cardiac bypass surgery), and inpatient mortality were analyzed across age, sex, and race/ethnic groups. There was significant variation in hospitalization rates by age and race/ethnicity. All racial/ethnic groups were less likely to undergo invasive procedures compared with white men (P<0.001). After adjustment for comorbidities, younger Hispanic women experienced higher in-hospital mortality compared with younger white men, with an odds ratio of 1.5 (95% CI 1.2 to 1.9), adjusted for age and comorbidities.


CONCLUSIONS
We found significant racial and sex disparities in AMI hospitalizations, care patterns, and mortality, with higher in-hospital mortality experienced by younger Hispanic women. Future studies are necessary to explore determinants of these significant racial and sex disparities in outcomes for AMI.
Division of Cardiovascular Medicine, Stanford University, Stanford, CA (R.).
Fátima
F
Rodriguez
Harvard Medical School, Massachusetts General Hospital, Boston, MA (J.A.M.F., L.) Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (J.A.M.F.).
JoAnne M
JM
Foody
Department of Biostatistics, Harvard School of Public Health, Boston, MA (Y.W.).
Yun
Y
Wang
Harvard Medical School, Massachusetts General Hospital, Boston, MA (J.A.M.F., L.) Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA (L.) Disparities Solutions Center, Massachusetts General Hospital, Boston, MA (L.) Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA (L.).
Lenny
L
López
D001741:Black or African American; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology; D006630:Hispanic or Latino; D017052:Hospital Mortality / Q000208:ethnology*; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality* / Q000628:therapy; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D044465:White People
acute myocardial infarction; disparities; outcomes; race/ethnicity; sex‐based differences