LB-3 | Sex Differences in Clinical Characteristics, Management Strategies and Outcomes of STEMI Patients with COVID-19
Notice bibliographique
Résumé
BackgroundSTEMI patients with COVID-19 have high mortality. Females are known to have different presentation and worse outcomes than males with STEMI.MethodsThe North American COVID-19 STEMI (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.ResultsAmong 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.ConclusionsIn 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.DisclosuresO. Quesada: National Institutes of Health (Heart, Lung and Blood): Principal Investigator for a Research Study; M. Madan: Medtronic: Advisory Board/Board Member; Novartis Canada: Advisory Board/Board Member; JAMP Pharma: Advisory Board/Board Member; Pendopharm: Advisory Board/Board Member; HLS Therapeutics: Consulting; S. Garcia: Edwards Lifesciences: Consulting and Principal Investigator for a Research Study; Medtronic: Consulting; C. Benziger: Amgen: Principal Investigator for a Research Study; Novartis: Principal Investigator for a Research Study; National Institutes of Health Aging (Preventable): Principal Investigator for a Research Study; Department of Defense (WARRIOR): Principal Investigator for a Research Study; Agency for Healthcare Research and Quality (TeenBP): Principal Investigator for a Research Study; L. Van Hon Nothing to disclose. M. Yildiz Nothing to disclose. C. Sanina Nothing to disclose. L. Davidson Nothing to disclose. W. W. Htun Nothing to disclose. J. Saw Nothing to disclose. P. Dehghani Nothing to disclose. L. Stanberry Nothing to disclose. T. D. Henry Nothing to disclose. C. L. Grines Nothing to disclose. BackgroundSTEMI patients with COVID-19 have high mortality. Females are known to have different presentation and worse outcomes than males with STEMI. STEMI patients with COVID-19 have high mortality. Females are known to have different presentation and worse outcomes than males with STEMI. MethodsThe North American COVID-19 STEMI (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. The North American COVID-19 STEMI (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. ResultsAmong 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. 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. ConclusionsIn 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. 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.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».