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Hall M, Smith L, Wu J, Hayward C, Batty JA, Lambert PC, Hemingway H, Gale CP. Health outcomes after myocardial infarction: A population study of 56 million people in England. PLoS Med 2024; 21:e1004343. [PMID: 38358949 PMCID: PMC10868847 DOI: 10.1371/journal.pmed.1004343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND The occurrence of a range of health outcomes following myocardial infarction (MI) is unknown. Therefore, this study aimed to determine the long-term risk of major health outcomes following MI and generate sociodemographic stratified risk charts in order to inform care recommendations in the post-MI period and underpin shared decision making. METHODS AND FINDINGS This nationwide cohort study includes all individuals aged ≥18 years admitted to one of 229 National Health Service (NHS) Trusts in England between 1 January 2008 and 31 January 2017 (final follow-up 27 March 2017). We analysed 11 non-fatal health outcomes (subsequent MI and first hospitalisation for heart failure, atrial fibrillation, cerebrovascular disease, peripheral arterial disease, severe bleeding, renal failure, diabetes mellitus, dementia, depression, and cancer) and all-cause mortality. Of the 55,619,430 population of England, 34,116,257 individuals contributing to 145,912,852 hospitalisations were included (mean age 41.7 years (standard deviation [SD 26.1]); n = 14,747,198 (44.2%) male). There were 433,361 individuals with MI (mean age 67.4 years [SD 14.4)]; n = 283,742 (65.5%) male). Following MI, all-cause mortality was the most frequent event (adjusted cumulative incidence at 9 years 37.8% (95% confidence interval [CI] [37.6,37.9]), followed by heart failure (29.6%; 95% CI [29.4,29.7]), renal failure (27.2%; 95% CI [27.0,27.4]), atrial fibrillation (22.3%; 95% CI [22.2,22.5]), severe bleeding (19.0%; 95% CI [18.8,19.1]), diabetes (17.0%; 95% CI [16.9,17.1]), cancer (13.5%; 95% CI [13.3,13.6]), cerebrovascular disease (12.5%; 95% CI [12.4,12.7]), depression (8.9%; 95% CI [8.7,9.0]), dementia (7.8%; 95% CI [7.7,7.9]), subsequent MI (7.1%; 95% CI [7.0,7.2]), and peripheral arterial disease (6.5%; 95% CI [6.4,6.6]). Compared with a risk-set matched population of 2,001,310 individuals, first hospitalisation of all non-fatal health outcomes were increased after MI, except for dementia (adjusted hazard ratio [aHR] 1.01; 95% CI [0.99,1.02];p = 0.468) and cancer (aHR 0.56; 95% CI [0.56,0.57];p < 0.001). The study includes data from secondary care only-as such diagnoses made outside of secondary care may have been missed leading to the potential underestimation of the total burden of disease following MI. CONCLUSIONS In this study, up to a third of patients with MI developed heart failure or renal failure, 7% had another MI, and 38% died within 9 years (compared with 35% deaths among matched individuals). The incidence of all health outcomes, except dementia and cancer, was higher than expected during the normal life course without MI following adjustment for age, sex, year, and socioeconomic deprivation. Efforts targeted to prevent or limit the accrual of chronic, multisystem disease states following MI are needed and should be guided by the demographic-specific risk charts derived in this study.
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Affiliation(s)
- Marlous Hall
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
| | - Lesley Smith
- Leeds Institute for Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Jianhua Wu
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Chris Hayward
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
| | - Jonathan A. Batty
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
| | - Paul C. Lambert
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, Leicester, United Kingdom
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Harry Hemingway
- Institute of Health Informatics, University College London, London, United Kingdom
- Health Data Research UK, University College London, London, United Kingdom
- NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, University College London, London, United Kingdom
- Charité Universitätsmedizin, Berlin, Germany
| | - Chris P. Gale
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
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Nedkoff L, Briffa T, Murray K, Gaw J, Yates A, Sanfilippo FM, Nicholls SJ. Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data study. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 17:200185. [PMID: 37122877 PMCID: PMC10139974 DOI: 10.1016/j.ijcrp.2023.200185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/18/2022] [Accepted: 03/30/2023] [Indexed: 05/02/2023]
Abstract
Background Survival during the early period following myocardial infarction (MI) has significantly improved although there are limited data on cardiovascular recurrence during this period. Methods We identified all emergency hospitalisations for MI from November 1, 2011 to October 31, 2016 in Western Australia from a linked hospitalisation/mortality dataset. Patients were included if they survived >3 days, had no acute kidney injury, and had ≥1 of: ≥65 years, prior MI, diabetes or peripheral arterial disease. Outcomes were major adverse cardiovascular events (MACE, a composite of CVD death, recurrent MI or stroke), cardiovascular disease (CVD) death, all-cause mortality, recurrent MI and stroke. Cumulative risks at 90-days and 1-year were estimated from Kaplan-Meier analyses and predictors of each outcome from multivariable Cox regression models. Results There were 8024 high-risk MI patients identified (males 61.8%). Median age was 73.7 years (IQR 66.3-82.2). Half of the risk of MACE occurred in the first 90-days post-MI (6.6% vs 12.6% at 1-year) and was underpinned by risk of recurrent MI. Risk was generally higher in women than men (MACE: 6.0% males, 7.7% females, p = 0.0025; CVD mortality: 1.7% males, 3.7% females; all-cause mortality: 2.8% males, 5.6% females, p < 0.0001). Independent predictors of 90-day MACE were increasing age, heart failure history, hypertension and prior stroke. Female sex was not associated with a higher rate of any of the outcomes after multivariable adjustment. Conclusion Half of cardiovascular events in the year following an MI occur within 90-days, demonstrating that reductions in MI burden could be achieved by further targeted intervention in the early period following an MI.
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Affiliation(s)
- Lee Nedkoff
- The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia
- Corresponding author. School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Hwy, Crawley, Western, 6009, Australia.
| | - Tom Briffa
- The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - Kevin Murray
- The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - James Gaw
- CSL Behring, 189 – 209 Camp Road, Broadmeadows, Victoria, 3047, Australia
| | - Andrea Yates
- CSL Behring, 189 – 209 Camp Road, Broadmeadows, Victoria, 3047, Australia
| | - Frank M. Sanfilippo
- The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - Stephen J. Nicholls
- Victorian Heart Institute, Monash University, Wellington Rd, Clayton, VIC, 3800, Australia
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Tetzlaff J, Tetzlaff F, Geyer S, Sperlich S, Epping J. Widening or narrowing income inequalities in myocardial infarction? Time trends in life years free of myocardial infarction and after incidence. Popul Health Metr 2021; 19:47. [PMID: 34952590 PMCID: PMC8709953 DOI: 10.1186/s12963-021-00280-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/10/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Despite substantial improvements in prevention and therapy, myocardial infarction (MI) remains a frequent health event, causing high mortality and serious health impairments. Previous research lacks evidence on how social inequalities in incidence and mortality risks developed over time, and on how these developments affect the lifespan free of MI and after MI in different social subgroups. This study investigates income inequalities in MI-free life years and life years after MI and whether these inequalities widened or narrowed over time. METHODS The analyses are based on claims data of a large German health insurance provider insuring approximately 2.8 million individuals in the federal state Lower Saxony. Trends in income inequalities in incidence and mortality were assessed for all subjects aged 60 years and older by comparing the time periods 2006-2008 and 2015-2017 using multistate survival models. Trends in the number of life years free of MI and after MI were calculated separately for income groups by applying multistate life table analyses. RESULTS MI incidence and mortality risks decreased over time, but declines were strongest among men and women in the higher-income group. While life years free of MI increased in men and women with higher incomes, no MI-free life years were gained in the low-income group. Among men, life years after MI increased irrespective of income group. CONCLUSIONS Income inequalities in the lifespan spent free of MI and after MI widened over time. In particular, men with low incomes are disadvantaged, as life years spent after MI increased, but no life years free of MI were gained.
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Affiliation(s)
- Juliane Tetzlaff
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany.
| | - Fabian Tetzlaff
- Institute for General Practice, Hannover Medical School, Hanover, Germany
| | - Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | | | - Jelena Epping
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
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Radisauskas R, Kirvaitiene J, Bernotiene G, Virviciutė D, Ustinaviciene R, Tamosiunas A. Long-Term Survival after Acute Myocardial Infarction in Lithuania during Transitional Period (1996-2015): Data from Population-Based Kaunas Ischemic Heart Disease Register. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:medicina55070357. [PMID: 31324034 PMCID: PMC6681332 DOI: 10.3390/medicina55070357] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 07/02/2019] [Indexed: 01/14/2023]
Abstract
Background and Objective: There is a lack of reliable epidemiological data on the long-term survival after acute myocardial infarction (AMI) in the Lithuanian population. The aim of the study was to evaluate the long-term (36 months) survival after AMI among persons aged 25–64 years, who had experienced AMI in four time-periods 1996, 2003–2004, 2008, and 2012. Material and Methods: The source of the data was Kaunas population-based Ischemic heart disease (IHD) register. Long-term survival after AMI (36 months) was evaluated using the Kaplan–Meier method. The survival curves significantly differed when p < 0.05. Hazard ratio for all-cause mortality and their 95% CIs, adjusted for baseline characteristics, were estimated with the Cox proportional hazards regression model. Results: The analysis of data on 36 months long-term survival among Kaunas population by sex and age groups showed that the survival rates among men and women were 83.4% and 87.6%, respectively (p < 0.05) and among 25–54 years-old and 55–64 years-old persons, 89.2% and 81.7%, respectively (p < 0.05). The rates of long-term survival of post-AMI Kaunas population were better in past periods than in first period. According to the data of the Kaplan-Meier survival analysis, long-term survival of 25 to 64-year-old post-AMI Kaunas population was without significantly difference in 1996, 2003–2004, 2008 and 2012 (Log-rank = 6.736, p = 0.081). The adjusted risk of all-cause mortality during 36 months among men and 25 to 54-year-old patients was on the average by 35% and 60% lower in 2012 than in 1996, respectively. Conclusion: It was found that 36 months survival post MI among women and younger (25–54 years) persons was significant better compared to men and older (55–64 years) persons. Long-term survival among 55 to 64-year-old post-AMI Kaunas population had a tendency to decrease during last period, while among 25–54 years old persons long-term survival was without significant changes. The results highlight the fact that AMI survivors, especially in youngest age, remain a high-risk group and reinforce the importance of primary and secondary prevention for the improvement of long-term prognosis of AMI patients.
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Affiliation(s)
- Ricardas Radisauskas
- Department of Environmental and Occupational Medicine, Medical Academy, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania.
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50103 Kaunas, Lithuania.
| | - Jolita Kirvaitiene
- Department of Environmental and Occupational Medicine, Medical Academy, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania
| | - Gailutė Bernotiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50103 Kaunas, Lithuania
| | - Dalia Virviciutė
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50103 Kaunas, Lithuania
| | - Ruta Ustinaviciene
- Department of Environmental and Occupational Medicine, Medical Academy, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania
| | - Abdonas Tamosiunas
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50103 Kaunas, Lithuania
- Department of Preventive Medicine, Medical Academy, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania
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Cost-Effectiveness of Exercise-Based Cardiac Rehabilitation in Chilean Patients Surviving Acute Coronary Syndrome. J Cardiopulm Rehabil Prev 2019; 39:168-174. [PMID: 31021998 DOI: 10.1097/hcr.0000000000000356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the cost-effectiveness of 3 models of exercise-based cardiac rehabilitation (CR) compared with standard care in survivors of acute coronary syndrome (ACS) within the public health system in Chile. METHODS A Markov model was designed using 5 health states: ACS survivor, second ACS, complications, general mortality, and cardiovascular mortality. The transition probabilities between health states for standard care and corresponding relative risk for CR were calculated from a systematic review. Health benefits were measured with the EuroQol 5-dimensional 3-level (EQ-5D-3L) survey. Costs for each health state were quantified using the national cost verification study. The CR cost was estimated with a microcosting methodology. The time horizon was a lifetime and the discount rate was 3% per year for costs and benefits. Deterministic and probabilistic analyses were performed. Structural uncertainty was managed by designing 3 scenarios: CR as currently delivered in a specific Chilean public health center, CR as recommended by South American guidelines, and CR as proposed for low-resource settings. RESULTS Cardiac rehabilitation versus standard care showed an incremental cost-effectiveness ratio for the standard model of $722, for the South American model of $1247, and for the low-resource model of $666. The tornado diagram showed higher uncertainty in relative risk for the complications state and for the second ACS state. CONCLUSION Considering a cost-effectiveness threshold of 1 unit of gross domestic product per capita (∼$19 000), CR is highly cost-effective for the public health system in Chile.
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AbuRuz ME, Al-Dweik G. Depressive Symptoms and Complications Early after Acute Myocardial Infarction: Gender Differences. Open Nurs J 2018; 12:205-214. [PMID: 30450145 PMCID: PMC6198415 DOI: 10.2174/1874434601812010205] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 08/05/2018] [Accepted: 09/10/2018] [Indexed: 12/11/2022] Open
Abstract
Background: Cardiovascular disease is the first leading cause of death worldwide. Coronary heart disease is the most common manifestation of cardiovascular disease. Acute myocardial infarction is the primary manifestation of coronary heart disease. Depression is a common and predicted complication after acute myocardial infarction. Limited studies evaluated gender differences in depressive symptoms after acute myocardial infarction especially in developing countries. Objective: The study aimed to determine whether there was a difference in depression levels and rate of complications based on gender early after acute myocardial infarction. Method: This was a prospective comparative study on 230 patients (150 men and 80 women) with a confirmed diagnosis of acute myocardial infarction. All participants signed an informed consent, filled sociodemographic and clinical questionnaire and the Depression Subscale of the Hospital Anxiety and Depression Scale. Clinical data were abstracted from the participants’ medical record after discharge. Results: Eighty-six participants (37.4%), 54 men and 32 women, developed 1 or more complications during hospitalization. Female patients were more depressed (14.4±3.5 vs. 8.3 ± 2.6) and developed more complications (1.9 ± 0.9 vs. 0.8 ± 0.5) than male patients did. Depressive symptoms increased the occurrence of complication by 40% and 33% for female and male patients respectively after controlling for sociodemographic and clinical variables. Conclusion: Depressive symptoms independently predicted complications after acute myocardial infarction in both men and women. The inclusion of depression assessment tools in acute myocardial infarction treatment protocols is highly recommended.
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Affiliation(s)
| | - Ghadeer Al-Dweik
- College of Nursing, Applied Science Private University, Amman, Jordan
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Geyer S, Eberhard S, Schmidt BMW, Epping J, Tetzlaff J. Morbidity compression in myocardial infarction 2006 to 2015 in terms of changing rates and age at occurrence: A longitudinal study using claims data from Germany. PLoS One 2018; 13:e0202631. [PMID: 30138437 PMCID: PMC6107226 DOI: 10.1371/journal.pone.0202631] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/07/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND According to James Fries morbidity compression is present if morbidity rates are decreasing to a larger extent than mortality rates. Compression also occurs if age at onset is increasing at a faster pace than age at death. These two variants of the compression hypothesis were formulated as a population concept. Compression has seldom been studied with a specific disease as application. METHODS Morbidity compression was examined in terms of myocardial infarction (MI) by using German claims data covering the years 2006 to 2015. The findings are based on an annual case number of about 2 m women and men aged 18 years and older. Analyses were performed by means of proportional hazards regression and by using linear regression. RESULTS Decreases of morbidity rates were more pronounced than those of mortality. For men, the hazard ratio for contracting MI in 2015 as compared to 2006 was hr = 0.66 and hr = 0.71 for the female population. The respective results for mortality were hr = 0.75 in men and hr = 1.0 in women. They can be interpreted in favor of morbidity compression. For the subgroup of women and men with MI, changes of onset age revealed marked gender differences. For 2015 as compared with 2006, age at MI-occurrence in men increased by 10.5 months as compared to an increase of 10.4 months for age at death. In women changes were smaller and statistically not significant. The findings referring to women have to be interpreted against the backdrop of higher onset age and higher age at death than in men. CONCLUSIONS Taken together, morbidity compression has occurred in terms of decreasing MI-rates as well as in terms of increased onset age in men. It can be concluded that both processes have led to an improvement of healthy lifetime. Decreasing morbidity rates in women are also pointing towards morbidity compression, a finding that is not complemented by changes of onset age. Our data are demonstrating that morbidity rates and age at onset may vary independently. From this perspective morbidity compression is a multi-faceted phenomenon.
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Affiliation(s)
- Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
- * E-mail:
| | - Sveja Eberhard
- Local Statutory Health Insurance of Lower Saxony (AOK Niedersachsen), Hannover, Germany
| | | | - Jelena Epping
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
| | - Juliane Tetzlaff
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
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Hernandez-Suarez DF, Osterman-Pla AD, Carrasquillo O, Aranda J, Baez S, Lopez M, Garcia-Rivera EJ. Epidemiological Profile of Hispanics Admitted With Acute Myocardial Infarction in Puerto Rico: The Experience of 2007, 2009 and 2011. J Clin Med Res 2017; 9:528-533. [PMID: 28496556 PMCID: PMC5412529 DOI: 10.14740/jocmr2926w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND A limited number of studies have been published about coronary artery disease in Hispanics, particularly among the Puerto Rican population. The aim of this study was to present a clinical epidemiological profile and management practices in patients hospitalized in Puerto Rico with acute myocardial infarction (AMI). METHODS This secondary data analysis from the Puerto Rico Cardiovascular Surveillance Study included 6,162 patients at 19 hospitals in Puerto Rico, during years 2007, 2009 and 2011. RESULTS The mean age of the patients diagnosed with AMI was 67 ± 13.6 years old, with women being older than men (P < 0.001). Women had a different risk factor burden when compared to men. Car/walked in was the principal mode of hospital transportation (65.9%). Women received less medications and cardiac procedures when compared to men. While no significant differences in length of hospital stay (LOS) were observed between genders, in-hospital mortality rate was higher in females when compared with males (6.5% vs. 4.5%; P < 0.001). CONCLUSION Prompt initiatives should be implemented to raise awareness, reduce gender disparities and improve outcomes in patients hospitalized with an AMI in Puerto Rico.
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Affiliation(s)
- Dagmar F Hernandez-Suarez
- Department of Medicine, School of Medicine, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico
| | - Anthony D Osterman-Pla
- Department of Medicine, School of Medicine, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico
| | - Onelys Carrasquillo
- Department of Medicine, School of Medicine, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico
| | - Juan Aranda
- Department of Medicine, School of Medicine, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico
| | - Stella Baez
- Department of Medicine, School of Medicine, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico
| | - Mariel Lopez
- University of Puerto Rico Endowed Health Services Research Center, San Juan, Puerto Rico
| | - Enid J Garcia-Rivera
- University of Puerto Rico Endowed Health Services Research Center, San Juan, Puerto Rico
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Davidson PM, Glass NE, DiGiacomo M. Global women's health issues: sex and gender matter. Med J Aust 2016; 205:346-348. [PMID: 27736616 DOI: 10.5694/mja16.00904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 08/29/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Patricia M Davidson
- Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, NSW
| | | | - Michelle DiGiacomo
- Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, NSW
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