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Am Heart J. 2017 Jan;183:74-84. doi: 10.1016/j.ahj.2016.09.012. Epub 2016 Oct 3.

Sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction: Results from the VIRGO study.

Author information

1
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT; Section of Cardiovascular Medicine and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
2
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT.
3
Quest Diagnostics Nichols Institute, San Juan Capistrano, CA.
4
Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
5
Yale-New Haven Hospital, New Haven, CT.
6
Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
7
Department of Internal Medicine, University of Michigan Health Systems, Ann Arbor, MI.
8
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT.
9
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Instituto de investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain.
10
University of Missouri-Kansas City and Saint Luke's Mid America Heart Institute, Kansas City, MO.
11
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT; Section of Cardiovascular Medicine and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT. Electronic address: harlan.krumholz@yale.edu.

Abstract

BACKGROUND:

Young women with acute myocardial infarction (AMI) have higher mortality risk than similarly aged men. An adverse lipid profile is an important risk factor for cardiovascular outcomes after AMI, but little is known about whether young women with AMI have a higher-risk lipid pattern than men. We characterized sex differences in lipid profiles and treatment utilization among young adults with AMI.

METHODS:

A total of 2,219 adults with AMI (1,494 women) aged 18-55 years were enrolled from 103 hospitals in the United States (2008-2012). Serum lipids and lipoprotein subclasses were measured 1 month after discharge.

RESULTS:

More than 90% of adults were discharged on a statin, but less than half received a high-intensity dose and 12% stopped taking treatments by 1 month. For both men and women, the median of low-density lipoprotein (LDL) cholesterol was reduced to <100 mg/dL 1 month after discharge for AMI, but high-density lipoprotein (HDL) cholesterol remained <40 mg/dL. Multivariate regression analyses showed that young women had favorable lipoprotein profiles compared with men: women had higher HDL cholesterol and HDL large particle, but lower total cholesterol-to-HDL cholesterol ratio and LDL small particle.

CONCLUSIONS:

Young women with AMI had slightly favorable lipid and lipoprotein profiles compared with men, suggesting that difference in lipid and lipoprotein may not be a major contributor to sex differences in outcomes after AMI. In both men and women, statin remained inadequately used, and low HDL cholesterol level was a major lipid abnormality.

PMID:
27979045
PMCID:
PMC5459396
DOI:
10.1016/j.ahj.2016.09.012
[Indexed for MEDLINE]
Free PMC Article

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