Sex-related disparities in incidence and in-hospital outcomes of Atrial fibrillation complicated by non-ST-elevation myocardial infarction from the national in-sample database (2016–2022)

Introduction

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, and if complicated by NSTEMI has a significant association with a higher all-cause and cardiovascular mortality. Previous studies show that patients with AF complicated by NSTEMI have a comparatively worse prognosis than AF patients without NSTEMI.

Methods

In this study, we aimed to assess the trends and gender-based disparities in the incidence and in-hospital outcomes of AF complicated by NSTEMI in the U.S. adult population, using data from the Nationwide Inpatient Sample (NIS) dataset. The NIS database was searched from 2016 to 2022 to identify patients with ICD-10 Codes. Baseline demographic characteristics along with hospital-level variables were analyzed subsequently using the odds ratio.

Results

The demographic, clinical, and hospital-related characteristics of the study population were stratified by gender including 125,340 males and 88,554 females. The average age of patients was 75.14 years, with males being younger (73.58 years) compared to females (77.35 years) (p < 0.001). Overall, 10.8 % of the patients died; females had a significantly higher mortality rate (11.3 %) than males (10.5 %) (p < 0.001). The trends in age-adjusted mortality rate (AAMR) was 19996.9 per 100,000 hospitalizations in males who demonstrated higher AAMRs than females (18156.5). The mean length of hospital stay was consistently longer for the males compared to the females. The trend analysis for inflation-adjusted hospital costs demonstrated an upward trend in both males (p < 0.001) and females (p < 0.001).

Conclusion

These findings underscore the importance of addressing gender-specific differences in the management of AF patients with NSTEMI to optimize patient resource allocation.