Trends of Incidence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection: A Population-Based Analysis

Ahmed N. Mahmoud; Siva Sagar Taduru; Amgad Mentias; Dhruv Mahtta; Amr F. Barakat; Marwan Saad; Akram Y. Elgendy; Mohammad K. Mojadidi; Mohamed Omer; Ahmed Abuzaid; Nayan Agarwal; Islam Y. Elgendy; R. David Anderson; Jacqueline Saw

doi:10.1016/j.jcin.2017.08.016

Trends of Incidence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection: A Population-Based Analysis

Ahmed N. Mahmoud
, Siva Sagar Taduru
, Amgad Mentias
, Dhruv Mahtta
, Amr F. Barakat
, Marwan Saad
, Akram Y. Elgendy
, Mohammad K. Mojadidi
, Mohamed Omer
, Ahmed Abuzaid
, Nayan Agarwal
, Islam Y. Elgendy
, R. David Anderson
, Jacqueline Saw

Producción científica: Article › revisión exhaustiva

121 Citas (Scopus)

Resumen

Objectives The authors sought to determine the clinical characteristics and in-hospital survival of women presenting with acute myocardial infarction (AMI) and spontaneous coronary artery dissection (SCAD). Background The clinical presentation and in-hospital survival of women with AMI and SCAD remains unclear. Methods The National Inpatient Sample (2009 to 2014) was queried for all women with a primary diagnosis of AMI and concomitant SCAD. Iatrogenic coronary dissection was excluded. The main outcome was in-hospital mortality. Propensity score matching and multivariable logistic regression analyses were performed. Results Among 752,352 eligible women with AMI, 7,347 had a SCAD diagnosis. Women with SCAD were younger (61.7 vs. 67.1 years of age) with less comorbidity. SCAD was associated with higher incidence of in-hospital mortality (6.8% vs. 3.4%). In SCAD patients, a decrease in in-hospital mortality was evident with time (11.4% in 2009 vs. 5.0% in 2014) and concurred with less percutaneous coronary intervention (PCI) (82.5% vs. 69.1%). Propensity score yielded 7,332 SCAD and 14,352 patients without SCAD. The odds ratio (OR) of in-hospital mortality remained higher with SCAD after propensity matching (OR: 1.87, 95% confidence interval [CI]: 1.65 to 2.11) and on multivariable regression analyses (OR: 2.41, 95% CI: 2.07 to 2.80). PCI was associated with higher mortality in SCAD patients presenting with non–ST-segment elevation myocardial infarction (OR: 2.01; 95% CI: 1.00 to 4.47), but not with STEMI (OR: 0.62; 95% CI: 0.41 to 0.96). Conclusions Women presenting with AMI and SCAD appear to be at higher risk of in-hospital mortality. Lower rates of PCI were associated with improved survival, with evidence of worse outcomes when PCI was performed for SCAD in the setting of non with ST-segment elevation myocardial infarction.

Idioma original	English
Páginas (desde-hasta)	80-90
Número de páginas	11
Publicación	JACC: Cardiovascular Interventions
Volumen	11
N.º	1
DOI	https://doi.org/10.1016/j.jcin.2017.08.016
Estado	Published - ene 8 2018

Nota bibliográfica

Publisher Copyright:
© 2018 American College of Cardiology Foundation

Financiación

Dr. Anderson is a consultant for Biosense Webster, a Johnson & Johnson Company. Dr. Saw has received research grants for SCAD research from the Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, University of British Columbia Division of Cardiology, AstraZeneca, Abbott Vascular, St. Jude Medical, and Servier; has been a consultant for Boston Scientific, Abbott Vascular, and St. Jude Medical; has received honoraria for proctoring from Boston Scientific and St. Jude Medical; and has received speaker honoraria for SCAD from AstraZeneca, St. Jude Medical, and Sunovion. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. The first two authors contributed equally to this work.

Financiadores
Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada
University of British Columbia Division of Cardiology
AstraZeneca
St. Jude Medical Center
Boston Scientific Neuromodulation Corporation
Servier Institute

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.jcin.2017.08.016

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Mahmoud, A. N., Taduru, S. S., Mentias, A., Mahtta, D., Barakat, A. F., Saad, M., Elgendy, A. Y., Mojadidi, M. K., Omer, M., Abuzaid, A., Agarwal, N., Elgendy, I. Y., Anderson, R. D., & Saw, J. (2018). Trends of Incidence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection: A Population-Based Analysis. JACC: Cardiovascular Interventions, 11(1), 80-90. https://doi.org/10.1016/j.jcin.2017.08.016

@article{05760257364747a3b434046dc7a70260,

title = "Trends of Incidence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection: A Population-Based Analysis",

abstract = "Objectives The authors sought to determine the clinical characteristics and in-hospital survival of women presenting with acute myocardial infarction (AMI) and spontaneous coronary artery dissection (SCAD). Background The clinical presentation and in-hospital survival of women with AMI and SCAD remains unclear. Methods The National Inpatient Sample (2009 to 2014) was queried for all women with a primary diagnosis of AMI and concomitant SCAD. Iatrogenic coronary dissection was excluded. The main outcome was in-hospital mortality. Propensity score matching and multivariable logistic regression analyses were performed. Results Among 752,352 eligible women with AMI, 7,347 had a SCAD diagnosis. Women with SCAD were younger (61.7 vs. 67.1 years of age) with less comorbidity. SCAD was associated with higher incidence of in-hospital mortality (6.8\% vs. 3.4\%). In SCAD patients, a decrease in in-hospital mortality was evident with time (11.4\% in 2009 vs. 5.0\% in 2014) and concurred with less percutaneous coronary intervention (PCI) (82.5\% vs. 69.1\%). Propensity score yielded 7,332 SCAD and 14,352 patients without SCAD. The odds ratio (OR) of in-hospital mortality remained higher with SCAD after propensity matching (OR: 1.87, 95\% confidence interval [CI]: 1.65 to 2.11) and on multivariable regression analyses (OR: 2.41, 95\% CI: 2.07 to 2.80). PCI was associated with higher mortality in SCAD patients presenting with non–ST-segment elevation myocardial infarction (OR: 2.01; 95\% CI: 1.00 to 4.47), but not with STEMI (OR: 0.62; 95\% CI: 0.41 to 0.96). Conclusions Women presenting with AMI and SCAD appear to be at higher risk of in-hospital mortality. Lower rates of PCI were associated with improved survival, with evidence of worse outcomes when PCI was performed for SCAD in the setting of non with ST-segment elevation myocardial infarction.",

keywords = "acute coronary syndrome(s), mortality, propensity score matching, women",

author = "Mahmoud, \{Ahmed N.\} and Taduru, \{Siva Sagar\} and Amgad Mentias and Dhruv Mahtta and Barakat, \{Amr F.\} and Marwan Saad and Elgendy, \{Akram Y.\} and Mojadidi, \{Mohammad K.\} and Mohamed Omer and Ahmed Abuzaid and Nayan Agarwal and Elgendy, \{Islam Y.\} and Anderson, \{R. David\} and Jacqueline Saw",

note = "Publisher Copyright: {\textcopyright} 2018 American College of Cardiology Foundation",

year = "2018",

month = jan,

day = "8",

doi = "10.1016/j.jcin.2017.08.016",

language = "English",

volume = "11",

pages = "80--90",

number = "1",

}

Mahmoud, AN, Taduru, SS, Mentias, A, Mahtta, D, Barakat, AF, Saad, M, Elgendy, AY, Mojadidi, MK, Omer, M, Abuzaid, A, Agarwal, N, Elgendy, IY, Anderson, RD & Saw, J 2018, 'Trends of Incidence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection: A Population-Based Analysis', JACC: Cardiovascular Interventions, vol. 11, n.º 1, pp. 80-90. https://doi.org/10.1016/j.jcin.2017.08.016

Trends of Incidence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection: A Population-Based Analysis. / Mahmoud, Ahmed N.; Taduru, Siva Sagar; Mentias, Amgad et al.
En: JACC: Cardiovascular Interventions, Vol. 11, N.º 1, 08.01.2018, p. 80-90.

Producción científica: Article › revisión exhaustiva

TY - JOUR

T1 - Trends of Incidence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection

T2 - A Population-Based Analysis

AU - Mahmoud, Ahmed N.

AU - Taduru, Siva Sagar

AU - Mentias, Amgad

AU - Mahtta, Dhruv

AU - Barakat, Amr F.

AU - Saad, Marwan

AU - Elgendy, Akram Y.

AU - Mojadidi, Mohammad K.

AU - Omer, Mohamed

AU - Abuzaid, Ahmed

AU - Agarwal, Nayan

AU - Elgendy, Islam Y.

AU - Anderson, R. David

AU - Saw, Jacqueline

PY - 2018/1/8

Y1 - 2018/1/8

N2 - Objectives The authors sought to determine the clinical characteristics and in-hospital survival of women presenting with acute myocardial infarction (AMI) and spontaneous coronary artery dissection (SCAD). Background The clinical presentation and in-hospital survival of women with AMI and SCAD remains unclear. Methods The National Inpatient Sample (2009 to 2014) was queried for all women with a primary diagnosis of AMI and concomitant SCAD. Iatrogenic coronary dissection was excluded. The main outcome was in-hospital mortality. Propensity score matching and multivariable logistic regression analyses were performed. Results Among 752,352 eligible women with AMI, 7,347 had a SCAD diagnosis. Women with SCAD were younger (61.7 vs. 67.1 years of age) with less comorbidity. SCAD was associated with higher incidence of in-hospital mortality (6.8% vs. 3.4%). In SCAD patients, a decrease in in-hospital mortality was evident with time (11.4% in 2009 vs. 5.0% in 2014) and concurred with less percutaneous coronary intervention (PCI) (82.5% vs. 69.1%). Propensity score yielded 7,332 SCAD and 14,352 patients without SCAD. The odds ratio (OR) of in-hospital mortality remained higher with SCAD after propensity matching (OR: 1.87, 95% confidence interval [CI]: 1.65 to 2.11) and on multivariable regression analyses (OR: 2.41, 95% CI: 2.07 to 2.80). PCI was associated with higher mortality in SCAD patients presenting with non–ST-segment elevation myocardial infarction (OR: 2.01; 95% CI: 1.00 to 4.47), but not with STEMI (OR: 0.62; 95% CI: 0.41 to 0.96). Conclusions Women presenting with AMI and SCAD appear to be at higher risk of in-hospital mortality. Lower rates of PCI were associated with improved survival, with evidence of worse outcomes when PCI was performed for SCAD in the setting of non with ST-segment elevation myocardial infarction.

AB - Objectives The authors sought to determine the clinical characteristics and in-hospital survival of women presenting with acute myocardial infarction (AMI) and spontaneous coronary artery dissection (SCAD). Background The clinical presentation and in-hospital survival of women with AMI and SCAD remains unclear. Methods The National Inpatient Sample (2009 to 2014) was queried for all women with a primary diagnosis of AMI and concomitant SCAD. Iatrogenic coronary dissection was excluded. The main outcome was in-hospital mortality. Propensity score matching and multivariable logistic regression analyses were performed. Results Among 752,352 eligible women with AMI, 7,347 had a SCAD diagnosis. Women with SCAD were younger (61.7 vs. 67.1 years of age) with less comorbidity. SCAD was associated with higher incidence of in-hospital mortality (6.8% vs. 3.4%). In SCAD patients, a decrease in in-hospital mortality was evident with time (11.4% in 2009 vs. 5.0% in 2014) and concurred with less percutaneous coronary intervention (PCI) (82.5% vs. 69.1%). Propensity score yielded 7,332 SCAD and 14,352 patients without SCAD. The odds ratio (OR) of in-hospital mortality remained higher with SCAD after propensity matching (OR: 1.87, 95% confidence interval [CI]: 1.65 to 2.11) and on multivariable regression analyses (OR: 2.41, 95% CI: 2.07 to 2.80). PCI was associated with higher mortality in SCAD patients presenting with non–ST-segment elevation myocardial infarction (OR: 2.01; 95% CI: 1.00 to 4.47), but not with STEMI (OR: 0.62; 95% CI: 0.41 to 0.96). Conclusions Women presenting with AMI and SCAD appear to be at higher risk of in-hospital mortality. Lower rates of PCI were associated with improved survival, with evidence of worse outcomes when PCI was performed for SCAD in the setting of non with ST-segment elevation myocardial infarction.

KW - acute coronary syndrome(s)

KW - mortality

KW - propensity score matching

KW - women

UR - https://www.scopus.com/pages/publications/85039054031

UR - https://www.scopus.com/pages/publications/85039054031#tab=citedBy

U2 - 10.1016/j.jcin.2017.08.016

DO - 10.1016/j.jcin.2017.08.016

M3 - Article

C2 - 29248409

AN - SCOPUS:85039054031

SN - 1936-8798

VL - 11

SP - 80

EP - 90

JO - JACC: Cardiovascular Interventions

JF - JACC: Cardiovascular Interventions

IS - 1

ER -

Trends of Incidence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection: A Population-Based Analysis

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