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Women Are Less Likely to Survive AMI Presenting With Out-of-Hospital Cardiac Arrest: A Nationwide Study.

Dafaalla, Mohamed; Rashid, Muhammad; Van Spall, Harriette G.C.; Mehta, Laxmi; Parwani, Purvi; Sharma, Garima; Bullock Palmer, Renee; Moledina, Saadiq; Santos Volgman, Annabelle; Mamas, Mamas


Harriette G.C. Van Spall

Laxmi Mehta

Purvi Parwani

Garima Sharma

Renee Bullock Palmer

Saadiq Moledina

Annabelle Santos Volgman


OBJECTIVE: To assess the impact of patient's sex on outcomes and management of acute myocardial infarction (AMI) patients presenting with out-of-hospital cardiac arrest (OHCA). PATIENTS AND METHODS: We conducted a population-based retrospective cohort study in AMI patients admitted with OHCA between 2010 and 2017 from the Myocardial Ischaemia National Audit Project (MINAP) registry. We used multivariable logistic regression models to evaluate the role of sex as a predictor of clinical outcomes and treatment strategy. RESULTS: Of 16,278 patients, women constituted almost one-quarter of the population (n=3710 [22.7%]). Women were older (median age 69 [IQR, 57-79] years vs 63 [IQR, 54-72] years, P<.001), experienced longer call-to-hospital-arrival time (median, 1.2 hours vs 1.1 hours; P=.008), were less likely to present with shockable rhythm (86.8% vs 91.5%, P<.001), and less likely to receive dual antiplatelet therapy (73.8% vs 78.6%, P<.001), beta blockers (64.7% vs 72.3%, P<.001), angiotensin-converting enzyme inhibitors (49.0% vs 55.3%, P<.001), coronary angiography (73.7% vs 83.3%, P<.001), and percutaneous coronary intervention (37.5% vs. 40.7%, p 0.004). After adjusting for patient characteristics and management, women had significantly higher odds of in-hospital death compared with men (odds ratio [OR], 1.3; 95% CI, 1.1 to 1.5) and lower odds of receiving coronary angiography (OR, 0.67; 95% CI, 0.59 to 0.75) and coronary artery bypass graft (OR, 0.28; 95% CI, 0.19 to 0.40). CONCLUSION: Women were less likely to survive following OHCA secondary to AMI. Hospital protocols that minimize physician bias and improve women-physician communication are needed to close this gap.

Journal Article Type Article
Acceptance Date Sep 1, 2022
Online Publication Date Sep 1, 2022
Publication Date Sep 1, 2022
Journal Mayo Clinic Proceedings
Print ISSN 0025-6196
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 97
Issue 9
Pages 1608 - 1618
Publisher URL