In this study, a cohort of AMI-CS admissions from the years 2000-2017, aged 18-55 years, was identified using the National Inpatient Sample. Use of noncardiac interventions, mechanical circulatory support, percutaneous coronary intervention, and coronary angiography was identified. The outcomes of interest included length of stay, hospitalization costs, cardiac interventions, and in-hospital mortality.

A total of 90,648 AMI-CS admissions, aged greater than or equal to 55 years were included, of which 26% were women. Higher rates of CS were noted in men compared with women. Women had lower rates of ST-segment elevation presentation (73% vs. 78.7%), acute non cardiac organ failure, cardiac arrest (34.3% vs. 35.7%), and received less-frequent coronary angiography (78.3% vs. 81.4%), early coronary angiography (49.2% vs. 54.1%), percutaneous coronary intervention (59.2% vs. 64.0%), and mechanical circulatory support (50.3% vs. 59.2%). Female sex was an independent predictor of in-hospital mortality (23.0% vs. 21.7%). Women had lower hospitalization costs ($156,372 vs. $167,669) but comparable lengths of stay compared with men.

In the young (i.e., aged less than or equal to 55 years) AMI-CS admissions, there remain significant sex disparities in the outcomes and management. Younger women had higher comorbidity, lower acuity of illness, lower use of coronary angiography, and PCI and greater in-hospital mortality.

Ref: https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.120.007154

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