LB-3
Sex Differences in Clinical Characteristics, Management Strategies, and Outcomes of STEMI Patients With COVID-19
Presenter
Odayme Quesada, MD, The Christ Hospital Health Network, Cincinnati, OH
Odayme Quesada, MD1, Logan Van Hon, MD2, Mina Madan, M.D., FSCAI3, Mehmet Yildiz1, Cristina Sanina, M.D.4, Laura Jean Davidson, MD, MS, FSCAI5, Wah Wah Htun, M.D., FSCAI6, Jacqueline Saw, M.D., FSCAI7, Santiago Garcia, M.D., FSCAI1, Payam Dehghani, MD8, Larissa Stanberry, PhD9, Timothy D. Henry, M.D., MSCAI10, Cindy L. Grines, M.D., MSCAI11 and Catherine Benziger, MD2, (1)The Christ Hospital Health Network, Cincinnati, OH, (2)Essentia Health, Duluth, MN, (3)Sunnybrook Health Sciences Centre, Toronto, ON, Canada, (4)Beth Israel Deaconess Medical Center, Bronx, NY, (5)Northwestern University Feinberg School of Medicine, Chicago, IL, (6)Gundersen Health System, La Crosse, WI, (7)Vancouver General Hospital, Vancouver, BC, Canada, (8)Prairie Vascular Research Network, Regina, SK, Canada, (9)Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, MN, (10)The Christ Hospital Health Network, Covington, KY, (11)Northside Hospital Cardiovascular Institute, Johns Creek, GA
Keywords: Acute Coronary Syndromes (ACS), COVID-19, Coronary and Women's Health
Background:
STEMI patients with COVID-19 have high mortality. Females are known to have different presentation and worse outcomes than males with STEMI.
Methods:
The
North
American
COVID-19 STE
MI (NACMI) registry is a prospective, multi-center registry of hospitalized STEMI patients with COVID-19 infection. We compared sex differences in clinical characteristics, management strategies and outcomes in those with confirmed COVID-19 infections.
Results:
Among 585 with STEMI and COVID-19, 154 (26.3%) were female. Compared to males, females were significantly older, had higher rates of diabetes and stroke/TIA and statin on admission (Table). Males were more likely to present with chest pain whereas females presented with dyspnea. Females more often had STEMI without an identified culprit lesion. Use of primary PCI as the reperfusion strategy was significantly higher in males, whereas medical therapy was higher in females. In-hospital mortality was 33% for females and 27% for males (p=0.217); there were also no significant sex differences in-hospital stroke or re-infarction, or composite primary endpoint.
Conclusions
:
In the largest study of STEMI patients with COVID-19 we found significant sex differences. Females were more likely to have no culprit lesion identified and treated with medical therapy, whereas males had culprit lesion identified and treated with primary PCI. In-hospital mortality was high for both sexes. Further investigation is needed to better understand sex-differences in the underlying etiology of STEMI.
