Sex Differences in the In-Hospital Mortality of Patients with Acute Myocardial Infarction: A Cross-Sectional Study in 36 Hospitals Across Germany

TL;DR

This study found no significant difference in in-hospital mortality between male and female patients with heart attacks in Germany.

Contribution

The study provides new evidence on sex differences in heart attack mortality using data from 36 German hospitals.

Findings

Women had higher in-hospital mortality (8.5%) compared to men (7.1%), but the difference was not statistically significant.

Female patients were older and more likely to have non-ST elevation heart attacks than male patients.

After adjusting for multiple factors, female sex was not significantly linked to higher mortality.

Abstract

Background and Objectives: Acute myocardial infarction (AMI) is one of the leading causes of mortality worldwide and caused ~1.8 million deaths in the European Union from 2012 to 2020. This study aimed to analyze and quantify sex-based disparities, identifying both clinical and systemic contributors to in-hospital mortality differences between male and female patients. Materials and Methods: This multicenter cross-sectional study from 36 hospitals across Germany included all hospitalized patients aged ≥18 years with admissions between January 2019 and December 2023 and a primary diagnosis of AMI. The primary outcome of the study was the prevalence of in-hospital mortality as a function of sex. Multivariable logistic regression analyses were conducted to assess the associations between female sex as compared with male sex and in-hospital mortality. Results: The present study included 9142 male and 4128 female patients with AMI. Women were significantly older than men (74.4 years versus 67.7 years). The proportion of non-ST elevation (NSTE-MI)-MI was higher in women than in men (70.7% versus 66.7%). Overall, in-hospital mortality was higher in women than in men (8.5% versus 7.1%). In a multivariable regression model, female sex was not significantly associated with in-hospital mortality (OR: 0.89; 95% CI: 0.77–1.04) irrespective of the MI type. Conclusions: There were no significant sex-based differences observed in the in-hospital mortality among patients suffering from AMI in Germany.

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