{
  "abstract": "Background STEMI remains a leading cause of morbidity and mortality worldwide. Prior studies suggest sex-based disparities in STEMI outcomes, but contemporary large-scale data remain limited. This study investigates sex differences in clinical presentation and mortality among 10,229 STEMI patients using data from the Irish Heart Attack Audit (IHAA) from 2017 to 2023.Methods A retrospective analysis was performed on STEMI cases between January 2017 and December 2023. Demographic and clinical data - including including age, sex, comorbidities, hemodynamic status and in-hospital mortality – were analysed. Primary outcomes were cardiogenic shock at presentation and in-hospital mortality. Logistic regression models were used to assess the association between sex and these outcomes. We adjusted for key risk factors – age, diabetes, chronic kidney disease and time to first medical contact – the time-interval with the greatest sex-based discrepancy (p < 0.001). A sex-age interaction term assessed whether any association between sex and outcomes varied with age ( table 1).Results Women accounted for 22.4% of patients. Compared to men, women had higher odds of presenting in cardiogenic shock in unadjusted analysis (OR: 1.29, 95% CI : 1.03 to 1.61; p = 0.028), with borderline association after adjustment (aOR: 4.60, 95% CI: 0.98 to 21.53; p = 0.053). In-hospital mortality was significantly higher in women (OR: 1.52, 95% CI: 1.27 to 1.83; p<0.001), and remained so after adjustment (aOR: 5.10, 95% CI: 1.20 to 21.67; p = 0.027). Age, CKD and time to FMC were significantly associated with both outcomes. The sex-age interaction term was significant, suggesting the relationship varied by age, with younger women experiencing higher mortality than younger men.Conclusion Women with STEMI had significantly higher in-hospital mortality and a possible increased risk of cardiogenic shock after adjusting for key clinical factors including age. These findings support the need for sex-specific strategies to improve STEMI outcomes ( figure 1).Abstract 10 Table 1Baseline characteristics with comparison by sex. Categorical variables - number (percentage) - compared using chi-squared test; Continuous variables - median (interquartile range) - compared using mann-whitney U testAbstract 10 Figure 1Prevalence of cardiogenic shock & in-hospital mortality by sex",
  "authors": [
    {
      "affiliations": [
        "Mater Misericordiae University Hospital, Dublin, Ireland"
      ],
      "name": "E Beirne"
    },
    {
      "affiliations": [
        "Royal College of Surgeons in Ireland, Dublin, Ireland"
      ],
      "name": "D Blake"
    },
    {
      "affiliations": [
        "Royal College of Surgeons in Ireland, Dublin, Ireland"
      ],
      "name": "M Daly"
    },
    {
      "affiliations": [
        "National Office of Clinical Audit, Dublin, Ireland"
      ],
      "name": "J McCormack"
    },
    {
      "affiliations": [
        "National Office of Clinical Audit, Dublin, Ireland"
      ],
      "name": "O Brych"
    },
    {
      "affiliations": [
        "Cork University Hospital, Cork, Ireland"
      ],
      "name": "E McFadden"
    },
    {
      "affiliations": [
        "Portlaoise General Hospital, Portlaoise, Ireland"
      ],
      "name": "S Fleming"
    },
    {
      "affiliations": [
        "Beaumont University Hospital, Dublin, Ireland"
      ],
      "name": "M Kennedy"
    },
    {
      "affiliations": [
        "St James’ Hospital, Dublin, Ireland"
      ],
      "name": "A Maree"
    },
    {
      "affiliations": [
        "University Hospital Limerick, Limerick, Ireland"
      ],
      "name": "T Kiernan"
    },
    {
      "affiliations": [
        "University Hospital Galway, Galway, Ireland"
      ],
      "name": "J Crowley"
    },
    {
      "affiliations": [
        "Mater Misericordiae University Hospital, Dublin, Ireland"
      ],
      "name": "R Margey"
    }
  ],
  "title": "10 Sex based disparities in STEMI outcomes: higher in-hospital mortality in women from a national registry of 10,229 patients",
  "uid": "97d8f6cb-ba7a-56d2-9e93-2e09c5d267a4"
}