2024
Sex differences in treatment strategies for pulmonary embolism in older adults: The SERIOUS-PE study of RIETE participants and US Medicare beneficiaries.
Bikdeli B, Leyva H, Muriel A, Lin Z, Piazza G, Khairani C, Rosovsky R, Mehdipour G, O'Donoghue M, Madridano O, Lopez-Saez J, Mellado M, Diaz Brasero A, Grandone E, Spagnolo P, Lu Y, Bertoletti L, López-Jiménez L, Jesús Núñez M, Blanco-Molina Á, Gerhard-Herman M, Goldhaber S, Bates S, Jimenez D, Krumholz H, Monreal M. Sex differences in treatment strategies for pulmonary embolism in older adults: The SERIOUS-PE study of RIETE participants and US Medicare beneficiaries. Vascular Medicine 2024, 1358863x241292023. PMID: 39588564, DOI: 10.1177/1358863x241292023.Peer-Reviewed Original ResearchRegistro Informatizado Enfermedad TromboEmbolicaIntermediate-risk PEInferior vena cavaPulmonary embolismFibrinolytic therapyAdvanced therapiesInferior vena cava filter placementUS Medicare beneficiariesSex differencesOlder adultsMedicare beneficiariesAnticoagulation patternsFilter placementVena cavaMale patientsClinical outcomesTreatment strategiesAssess sex differencesPE therapyTherapyRisk factorsStandardized differenceAnticoagulationTherapy utilizationSex disparities
2023
Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients
Sawano M, Lu Y, Caraballo C, Mahajan S, Dreyer R, Lichtman J, D'Onofrio G, Spatz E, Khera R, Onuma O, Murugiah K, Spertus J, Krumholz H. Sex Difference in Outcomes of Acute Myocardial Infarction in Young Patients. Journal Of The American College Of Cardiology 2023, 81: 1797-1806. PMID: 37137590, DOI: 10.1016/j.jacc.2023.03.383.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoncardiac hospitalizationsSubdistribution HRYounger patientsMyocardial infarctionSex differencesYoung womenCause-specific hospitalizationsCause of hospitalizationWorse health statusSignificant sex disparityNoncardiovascular hospitalizationsVIRGO StudyIndex episodeAdverse outcomesIncidence rateHospitalizationHigh riskSex disparitiesHealth statusPatientsU.S. hospitalsWomenInfarctionOutcomesSex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction
Brush J, Chaudhry S, Dreyer R, D'Onofrio G, Greene E, Hajduk A, Lu Y, Krumholz H. Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction. The American Journal Of Cardiology 2023, 197: 101-107. PMID: 37062667, PMCID: PMC10198892, DOI: 10.1016/j.amjcard.2023.03.009.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionD2B timeSymptom complexityYoung womenChest painBalloon timeST-elevation myocardial infarctionSILVER-AMI StudySymptom phenotypeSex differencesPain symptomsCoronary interventionOlder patientsMyocardial infarctionOlder womenSTEMIOlder menSymptom patternsPresentation delayPatientsSymptom clustersLogistic regressionSymptomsWomenMean numberSex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study
Bikdeli B, Muriel A, Wang Y, Piazza G, Khairani C, Rosovsky R, Mehdipoor G, O'Donoghue M, Madridano O, Lopez-Saez J, Mellado M, Brasero A, Grandone E, Spagnolo P, Lu Y, Bertoletti L, López-Jiménez L, Núñez M, Blanco-Molina Á, Gerhard-Herman M, Goldhaber S, Bates S, Jimenez D, Krumholz H, Monreal M. Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study. Seminars In Thrombosis And Hemostasis 2023, 49: 725-735. PMID: 36868268, DOI: 10.1055/s-0043-1764231.Peer-Reviewed Original ResearchConceptsOlder adultsClinical characteristicsRisk factorsElderly womenPE risk stratificationTransient provoking factorsRelevant clinical characteristicsSex differencesWarrants further investigationSex-related differencesSex-specific factorsClot burdenPE presentationChest painHormonal therapyHormone therapyPatient characteristicsPulmonary embolismYounger patientsAtherosclerotic diseaseRisk stratificationLung diseaseMedicare databaseProvoking factorsCardiovascular disease
2022
Hemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography
Caraballo C, Mahajan S, Gu J, Lu Y, Spatz ES, Dreyer RP, Zhang M, Sun N, Ren Y, Zheng X, Zhao H, Lu H, J. Z, Krumholz HM. Hemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography. PLOS ONE 2022, 17: e0269777. PMID: 35700163, PMCID: PMC9197037, DOI: 10.1371/journal.pone.0269777.Peer-Reviewed Original ResearchConceptsElevated blood pressureSystemic vascular resistance indexVascular resistance indexBlood pressureCardiac indexResistance indexHigh systemic vascular resistance indexLower systemic vascular resistance indexHigher mean systolic blood pressureMean diastolic blood pressureMean systolic blood pressureImpedance cardiographyLow cardiac indexHigher cardiac indexDiastolic blood pressureSystolic blood pressureBody mass indexYear old womanPersonalization of treatmentSame age groupNon-invasive assessmentSex differencesHemodynamic profileMass indexHemodynamic differencesSex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015
Guo W, Du X, Gao Y, Hu S, Lu Y, Dreyer RP, Li X, Spatz ES, Masoudi FA, Krumholz HM, Zheng X. Sex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008535. PMID: 35607994, PMCID: PMC9208815, DOI: 10.1161/circoutcomes.121.008535.Peer-Reviewed Original ResearchConceptsSegment elevation myocardial infarctionInvasive strategyMyocardial infarctionHospital mortalityHospital outcomesMultivariable logistic regression modelCardiovascular risk factorsElevation myocardial infarctionSex-related disparitiesQuality of careProportion of womenLogistic regression modelsSex differencesClinical characteristicsClinical profileRisk factorsClinical covariatesSex-specific differencesPatientsInfarctionST segmentSex gapChinese hospitalsMortalityWomenSex Differences in PrEsentation, Risk Factors, Drug and Interventional Therapies, and OUtcomes of Elderly PatientS with Pulmonary Embolism: Rationale and design of the SERIOUS-PE study
Bikdeli B, Piazza G, Jimenez D, Muriel A, Wang Y, Khairani CD, Rosovsky RP, Mehdipoor G, O'Donoghue ML, Spagnolo P, Dreyer RP, Bertoletti L, López-Jiménez L, Núñez MJ, Blanco-Molina Á, Bates SM, Gerhard-Herman M, Goldhaber SZ, Monreal M, Krumholz HM. Sex Differences in PrEsentation, Risk Factors, Drug and Interventional Therapies, and OUtcomes of Elderly PatientS with Pulmonary Embolism: Rationale and design of the SERIOUS-PE study. Thrombosis Research 2022, 214: 122-131. PMID: 35537232, DOI: 10.1016/j.thromres.2022.04.019.Peer-Reviewed Original ResearchConceptsRisk factorsElderly patientsUS Medicare feeInterventional therapyMedicare feeInternational registryService beneficiariesSex differencesNational US databasePrognostic prediction rulePulmonary embolism studyLarge international registryPrincipal discharge diagnosisSex-based disparitiesAssessment of outcomesPotential sex differencesSex-specific findingsPE presentationPulmonary embolismVenous thromboembolismTreatment patternsDischarge diagnosisAvailable therapiesDisease presentationTreatment-based differences
2021
Sex Differences in Symptom Phenotypes Among Older Patients with Acute Myocardial Infarction
Brush JE, Hajduk AM, Greene EJ, Dreyer RP, Krumholz HM, Chaudhry SI. Sex Differences in Symptom Phenotypes Among Older Patients with Acute Myocardial Infarction. The American Journal Of Medicine 2021, 135: 342-349. PMID: 34715061, PMCID: PMC8901454, DOI: 10.1016/j.amjmed.2021.09.022.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionSymptom combinationsOlder patientsAcute myocardial infarction subgroupsAcute myocardial infarction admissionsMyocardial infarction subgroupsPatients 75 yearsMyocardial infarction admissionsSILVER-AMI StudySymptom phenotypeClinical studiesIndividual patientsMore symptomsPatientsInfarctionDiagnostic possibilitiesSymptomsWomenPerson interviewsMenCommon phenotypeSex differencesCliniciansPhenotype
2020
Sex Differences in 1‐Year Health Status Following Percutaneous Coronary Intervention in Patients Without Acute Myocardial Infarction: Results From the China PEACE Prospective Study
Zheng X, Dreyer RP, Curtis JP, Liu S, Xu X, Bai X, Li X, Zhang H, Wang S, Masoudi FA, Spertus JA, Li J, Krumholz HM, Group F. Sex Differences in 1‐Year Health Status Following Percutaneous Coronary Intervention in Patients Without Acute Myocardial Infarction: Results From the China PEACE Prospective Study. Journal Of The American Heart Association 2020, 9: e014421. PMID: 32131687, PMCID: PMC7335522, DOI: 10.1161/jaha.119.014421.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionAcute myocardial infarctionSAQ Summary ScoreCoronary interventionHealth status outcomesMyocardial infarctionHealth statusSummary scoresSAQ qualityAngina frequencyStatus outcomesPercutaneous coronary intervention studiesSAQ angina frequency scoreAngina frequency scoreCoronary Intervention StudyMarginal clinical significanceSAQ angina frequencyCardiac risk factorsChinese tertiary hospitalBackground Sex differencesSex differencesMultivariable adjustmentDiabetes mellitusTertiary hospitalLife scores
2018
Sex differences in health outcomes at one year following acute myocardial infarction: A report from the China Patient-Centered Evaluative Assessment of Cardiac Events prospective acute myocardial infarction study
Dreyer RP, Zheng X, Xu X, Liu S, Li J, Ding Q, Du X, Li X, Zhang H, Masoudi FA, Spertus JA, Krumholz HM, Jiang L. Sex differences in health outcomes at one year following acute myocardial infarction: A report from the China Patient-Centered Evaluative Assessment of Cardiac Events prospective acute myocardial infarction study. European Heart Journal Acute Cardiovascular Care 2018, 8: 273-282. PMID: 30270637, DOI: 10.1177/2048872618803726.Peer-Reviewed Original ResearchConceptsMajor adverse cardiac eventsDisease-specific health statusAdverse cardiac eventsAcute myocardial infarctionGeneric health statusMyocardial infarctionCardiac eventsFemale sexHealth statusWeekly anginaChina PatientHealth outcomesAcute Myocardial Infarction StudyPost-acute myocardial infarctionAcute myocardial infarction patientsLong-term health outcomesCardiac Events (PEACE) studyMyocardial Infarction StudyMyocardial infarction patientsSpecific health statusHigher crude ratesSex differencesCardiovascular deathMultivariable analysisInfarction patientsSex Differences in Omega‐3 and ‐6 Fatty Acids and Health Status Among Young Adults With Acute Myocardial Infarction: Results From the VIRGO Study
Lu Y, Ding Q, Xu X, Spatz ES, Dreyer RP, D'Onofrio G, Caulfield M, Nasir K, Spertus JA, Krumholz HM. Sex Differences in Omega‐3 and ‐6 Fatty Acids and Health Status Among Young Adults With Acute Myocardial Infarction: Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e008189. PMID: 29848494, PMCID: PMC6015388, DOI: 10.1161/jaha.117.008189.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth status scoresArachidonic acidVIRGO StudyStatus scoreMyocardial infarctionHealth statusPoorer health status outcomesYoung menPatient-reported health statusYoung womenOmega-3 fatty acidsSex differencesPatient-reported outcomesFatty acidsHealth status outcomesCardiovascular outcomesClinical characteristicsAdjusted analysisAMI patientsRisk factorsUS adultsStatus outcomesOmega-3Women 1Sex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics
Gupta A, Barrabes JA, Strait K, Bueno H, Porta‐Sánchez A, Acosta‐Vélez J, Lidón R, Spatz E, Geda M, Dreyer RP, Lorenze N, Lichtman J, D'Onofrio G, Krumholz HM. Sex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics. Journal Of The American Heart Association 2018, 7: e007021. PMID: 29514807, PMCID: PMC5907538, DOI: 10.1161/jaha.117.007021.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge of OnsetElectrocardiographyFemaleHealthcare DisparitiesHumansMaleMiddle AgedMyocardial ReperfusionPredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSex FactorsSpainST Elevation Myocardial InfarctionTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsST-segment elevation myocardial infarctionElectrocardiographic characteristicsMyocardial infarctionReperfusion delayYounger patientsVentricular hypertrophyST elevationPrehospital ECGLateral leadsMultivariable logistic regression modelTimeliness of reperfusionVoltage criteriaElevation myocardial infarctionLeft ventricular hypertrophyAcute myocardial infarctionYears of ageLogistic regression modelsSex differencesClinical characteristicsCohort studyElectrocardiographic correlatesMultivariable analysisFemale sexSpanish hospitalsReperfusion guidelines
2017
Sex Differences in Trajectories of Risk After Rehospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia
Dreyer RP, Dharmarajan K, Hsieh AF, Welsh J, Qin L, Krumholz HM. Sex Differences in Trajectories of Risk After Rehospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003271. PMID: 28506980, PMCID: PMC5650228, DOI: 10.1161/circoutcomes.116.003271.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHeart failureReadmission riskDaily riskImmediate postdischarge periodRisk of rehospitalizationSex differencesDeath 1 yearPrincipal discharge diagnosisHospitalization of patientsAssociation of sexRehospitalization riskPostdischarge periodDischarge diagnosisMedicare patientsHigh riskMortality riskMedicare feeTrajectories of riskRehospitalizationInfarctionService beneficiariesHospitalizationPneumoniaSex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction
Lu Y, Zhou S, Dreyer RP, Spatz ES, Geda M, Lorenze NP, D'Onofrio G, Lichtman JH, Spertus JA, Ridker PM, Krumholz HM. Sex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003470. PMID: 28228461, PMCID: PMC5459381, DOI: 10.1161/circoutcomes.116.003470.Peer-Reviewed Original ResearchMeSH Keywords1-Alkyl-2-acetylglycerophosphocholine EsteraseAdolescentAdultAge of OnsetBiomarkersChi-Square DistributionComorbidityC-Reactive ProteinFemaleHealth Status DisparitiesHumansInflammation MediatorsLinear ModelsMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocioeconomic FactorsUnited StatesUp-RegulationYoung AdultConceptsHigh-sensitivity C-reactive proteinAcute myocardial infarctionHigher inflammatory levelsInflammatory markersPoor health statusHealth statusYoung womenMyocardial infarctionInflammatory levelsTargeted anti-inflammatory treatmentsElevated inflammatory markersResidual cholesterol riskResidual inflammatory riskSex differencesAnti-inflammatory treatmentAnti-inflammatory therapyC-reactive proteinHigher mortality riskYoung menPhospholipase A2Years of ageCardiovascular outcomesMultivariable adjustmentPatient characteristicsSecondary preventionSex Differences in 1-Year All-Cause Rehospitalization in Patients After Acute Myocardial Infarction
Dreyer RP, Dharmarajan K, Kennedy KF, Jones PG, Vaccarino V, Murugiah K, Nuti SV, Smolderen KG, Buchanan DM, Spertus JA, Krumholz HM. Sex Differences in 1-Year All-Cause Rehospitalization in Patients After Acute Myocardial Infarction. Circulation 2017, 135: 521-531. PMID: 28153989, PMCID: PMC5312975, DOI: 10.1161/circulationaha.116.024993.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionAge-sex interactionHigh riskRehospitalization ratesClinical factorsMyocardial infarctionCox proportional hazards modelSignificant age-sex interactionCause rehospitalization rateSex differencesMedical record abstractionProportional hazards modelYears of ageFirst yearTRIUMPH studyCause rehospitalizationRecord abstractionPatient interviewsRehospitalizationUS CentersHazards modelPsychosocial factorsPhysician panelHealth statusPsychosocial statePerceived Stress After Acute Myocardial Infarction
Xu X, Bao H, Strait KM, Edmondson DE, Davidson KW, Beltrame JF, Bueno H, Lin H, Dreyer RP, Brush JE, Spertus JA, Lichtman JH, D'Onofrio G, Krumholz HM. Perceived Stress After Acute Myocardial Infarction. Psychosomatic Medicine 2017, 79: 50-58. PMID: 27984507, PMCID: PMC5459399, DOI: 10.1097/psy.0000000000000429.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPSS-14 scoreMiddle-aged patientsPatient characteristicsMyocardial infarctionSex differencesMonths of recoveryAMI anginaInitial hospitalizationPerceived Stress ScalePatientsAnginaLess improvementLinear mixed-effects modelsFirst monthPsychological stressMixed-effects modelsWomenMonthsHigh levelsMenInfarctionStress ScalePerceived stress
2016
Sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction: Results from the VIRGO study
Lu Y, Zhou S, Dreyer RP, Caulfield M, Spatz ES, Geda M, Lorenze NP, Herbert P, D'Onofrio G, Jackson EA, Lichtman JH, Bueno H, Spertus JA, Krumholz HM. Sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction: Results from the VIRGO study. American Heart Journal 2016, 183: 74-84. PMID: 27979045, PMCID: PMC5459396, DOI: 10.1016/j.ahj.2016.09.012.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionLipid profileYoung womenLipoprotein cholesterolLipoprotein profileMyocardial infarctionTreatment utilizationLow-density lipoprotein cholesterolHigh-density lipoprotein cholesterolLow HDL cholesterol levelsYoung adultsHigh-intensity doseMajor lipid abnormalitiesSex differencesAdverse lipid profileFavorable lipoprotein profileHDL cholesterol ratioLower total cholesterolHDL cholesterol levelsHigher HDL cholesterolImportant risk factorHigher mortality riskMultivariate regression analysisVIRGO StudyCardiovascular outcomesSex Differences in Financial Barriers and the Relationship to Recovery After Acute Myocardial Infarction
Beckman AL, Bucholz EM, Zhang W, Xu X, Dreyer RP, Strait KM, Spertus JA, Krumholz HM, Spatz ES. Sex Differences in Financial Barriers and the Relationship to Recovery After Acute Myocardial Infarction. Journal Of The American Heart Association 2016, 5: e003923. PMID: 27742618, PMCID: PMC5121496, DOI: 10.1161/jaha.116.003923.Peer-Reviewed Original ResearchMeSH KeywordsAdultAftercareDepressionDrug CostsFemaleHealth Services AccessibilityHumansIncomeLinear ModelsMaleMedication AdherenceMiddle AgedMultivariate AnalysisMyocardial InfarctionPatient Health QuestionnaireProspective StudiesRecovery of FunctionSex FactorsSocioeconomic FactorsSpainUnited StatesConceptsAcute myocardial infarctionMyocardial infarctionFinancial barriersHealth status 12 monthsYoung adultsPost-AMI outcomesYear post-AMIYoung AMI patientsMultivariable linear regression modelsGreater depressive symptomatologyMental functional statusSex differencesClinical characteristicsYounger patientsAMI patientsPost-AMIFunctional statusWorse outcomesBaseline healthPsychosocial statusOutcomes 1Depressive symptomatologyPatientsMore womenHealth careSex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study
Du X, Spatz ES, Dreyer RP, Hu S, Wu C, Li X, Li J, Wang S, Masoudi FA, Spertus JA, Nasir K, Krumholz HM, Jiang L, Group F. Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study. Journal Of The American Heart Association 2016, 5: e002157. PMID: 26903002, PMCID: PMC4802449, DOI: 10.1161/jaha.115.002157.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionQuality of careEvidence-based therapiesMyocardial infarctionClinical profileHospitalization ratesST-segment elevation myocardial infarction presentationSex differencesMyocardial infarction presentationYounger age groupsProportion of womenMyocardial infarction hospitalizationsEarly aspirinHospital deathCardiac eventsHospital admissionMedian ageSymptom onsetChina PatientRetrospective studyAdmission timeHigh riskSex disparitiesPatientsReturn to Work After Acute Myocardial Infarction
Dreyer RP, Xu X, Zhang W, Du X, Strait KM, Bierlein M, Bucholz EM, Geda M, Fox J, D'Onofrio G, Lichtman JH, Bueno H, Spertus JA, Krumholz HM. Return to Work After Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2016, 9: s45-s52. PMID: 26908859, PMCID: PMC4771977, DOI: 10.1161/circoutcomes.115.002611.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionYoung AMI Patients (VIRGO) studyPrevious coronary diseaseYoung populationPatients' sociodemographic characteristicsSex differencesMedical record abstractionMultivariable regression analysisCoronary diseasePatient characteristicsYounger patientsRecord abstractionPatient interviewsHealth characteristicsPsychosocial factorsWorse recoverySociodemographic characteristicsHealth measuresGreater riskYoung womenPhysical healthPatient studiesHigher likelihoodYoung men