Gender Disparities in Presentation, Management, and Outcomes of Acute Myocardial Infarction

Abstract

Purpose of Review: This review provides updates in gender disparities in the symptom profile, risk factors, quality and timeliness of guideline-based medical care, and clinical outcomes, including mortality, bleeding, and vascular complications, in patients with acute myocardial infarction (AMI). Recent Findings: While AMI continues to be a leading cause of mortality in both men and women, significant gender differences exist in presentation, management, and outcomes. Women with AMI are older, suffer atypical symptoms, and more often present with HF and cardiogenic shock. Delays in medical care and hence longer ischemic times exist in women, partly due to decreased awareness and lack of symptom recognition. Women continue to be less likely to receive guideline-based pharmacological therapies and revascularization than men with AMI. While women suffer from significantly higher risk-adjusted rates of bleeding, vascular complications, and short-term mortality, the risk-adjusted rates of long-term mortality remain similar between men and women. Further investigations and efforts are needed to aggressively modify risk factors, reduce delays in care, and address the higher rates of adverse events seen in women with AMI. Summary: Significant sex disparities are prevalent in presentation, management, and outcomes of adults with AMI. Further investigations and efforts are needed to aggressively modify risk factors, reduce delays in care, and address the higher rates of adverse events seen in women with AMI.