LB-3 | Sex Differences in Clinical Characteristics, Management Strategies and Outcomes of STEMI Patients with COVID-19
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".