Sex-Based Differences in Clinical Outcomes of Acute Coronary Syndrome Among Patients With Mediastinal Radiation Exposure: Insights From The National Inpatient Sample (2009-2020)

Authors

Mohammed Faisaluddin, Rochester Regional HealthFollow
Muhammad Osama, Rochester Regional HealthFollow
Asmaa Ahmed, Rochester Regional HealthFollow
Mariam Asif, Department of Medicine, King Faisal University, Riyadh, Saudi Arabia.
Ambica Nair, Department of Internal Medicine, Ocean University Medical Center, Brick, NJ.
Harsh Patel, Department of Cardiology, Southern Illinois University School of Medicine, Springfield, IL.
Samarthkumar Thakkar, Department of Cardiology, Houston Methodist Hospital, Houston, TX.
Abdul Mannan Minhas, Department of Medicine, University of Mississippi Medical Center, Jackson, MS.
Uzma Iqbal, Rochester Regional HealthFollow
Sarju Ganatra, Department of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA.
Sourbha S. Dani, Department of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA. Electronic address: Sourbha.s.dani@lahey.org.

Department

Internal Medicine

Additional Department

Cardiology

Document Type

Article

Publication Title

Current Problems in Cardiology

Abstract

There is a paucity of data about the sex differences in acute coronary syndrome (ACS) outcomes in patients with prior mediastinal radiation. The National Inpatient Sample database from years 2009 to 2020 were queried for ACS hospitalizations of patients with prior mediastinal radiation. The primary outcome was MACCE (major cardiovascular events), and secondary outcomes included other clinical outcomes. A total of 23,385 hospitalizations for ACS with prior mediastinal radiation exposure ([15,904 (68.01%) females, and 7481 (31.99%) males]) were included in analysis. Males were slightly younger than females (median, age (70 [62-78] vs 72 [64-80]). Female patients with ACS had a higher burden of hypertension (80.82% vs 73.55%), diabetes mellitus (33% vs 28.35%), hyperlipidemia (66.09% vs 62.2%), obesity (17.02% vs 8.6%) however, males had a higher burden of peripheral vascular disease (18.29% vs 12.51%), congestive heart failure (41.8% vs 39.35%) and smoking (70.33% vs 46.92%). After propensity matching, primary outcome MACCE was higher in males (20.85% vs 13.29%, aOR: 1.80 95% CI (1.65-1.96), P < 0.0001) along with cardiogenic shock (8.74% vs 2.42%, aOR: 1.77 95% CI (1.55-2.02), P < 0.0001) and mechanical circulatory support use (aOR: 1.48 95% CI [1.29 -1.71], P < 0.0001). We observed no differences in the length of hospital stay, however total hospitalization cost was higher in males. This nationwide analysis showed significant disparities in outcomes among male and female ACS patients with prior mediastinal radiation history, with increasing trend in hospitalization for ACS among males and females but decreasing mortality among females.

First Page

101919

DOI

10.1016/j.cpcardiol.2023.101919

Volume

48

Issue

10

Publication Date

10-1-2023

PubMed ID

37402423

Recommended Citation

Faisaluddin, M., Osama, M., Ahmed, A., Asif, M., Nair, A., Patel, H., Thakkar, S., Minhas, A. M., Iqbal, U., Ganatra, S., & Dani, S. S. (2023). Sex-Based Differences in Clinical Outcomes of Acute Coronary Syndrome Among Patients With Mediastinal Radiation Exposure: Insights From The National Inpatient Sample (2009-2020). Current Problems in Cardiology, 48 (10), 101919. https://doi.org/10.1016/j.cpcardiol.2023.101919