Photo Credit: Rasi Bhadramani

The following is a summary of “Sex differences in outcomes in patients with acute myocardial infarction,” published in the April 2025 issue of BMC Cardiovascular Disorders by Cai et al. 

Sex is a critical factor influencing the development, progression, and treatment outcomes of cardiovascular diseases. This study aimed to investigate sex-based differences in the prognosis of patients with acute myocardial infarction (AMI), utilizing data from the MIMIC III and IV databases.

Patients diagnosed with AMI were retrospectively analyzed. The primary endpoint was 1-year all-cause mortality. Secondary endpoints included in-hospital all-cause mortality, 28-day all-cause mortality, and in-hospital complications such as acute kidney injury (AKI) and ventricular arrhythmias (VA). Kaplan-Meier survival analysis was used to compare survival rates between sexes. Additionally, Cox proportional hazards regression and logistic regression models were employed to determine whether sex served as an independent predictor of outcomes in patients with AMI.

A total of 4,890 patients with AMI were included in the analysis. At the 1-year follow-up, mortality was observed in 722 (22.5%) male patients and 558 (33.2%) female patients. After adjusting for confounding factors, men exhibited a 17.9% lower risk of all-cause mortality compared to women ([HR] = 0.821; 95% [CI]: 0.684–0.987). Kaplan-Meier survival curves demonstrated a significantly higher 1-year survival rate among men relative to women (HR = 0.532; 95% CI: 0.444–0.638; log-rank P < 0.0001). No significant sex-based differences were noted in the incidence of AKI during hospitalization. However, after multivariable adjustment, male patients demonstrated a 25% higher risk of developing in-hospital ventricular arrhythmias compared to female patients ([OR] = 1.250; 95% CI: 1.030–1.518).

This study highlights significant sex-based disparities in outcomes among patients with AMI. Women experienced higher 1-year all-cause mortality compared to men, whereas men exhibited a greater risk of ventricular arrhythmias during hospitalization. These findings underscore the importance of incorporating sex-specific considerations into the management and prognostication of patients with acute myocardial infarction.

Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-025-04713-9