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 number
2022
Sex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults
Lu Y, Li SX, Liu Y, Rodriguez F, Watson KE, Dreyer RP, Khera R, Murugiah K, D’Onofrio G, Spatz ES, Nasir K, Masoudi FA, Krumholz HM. Sex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults. JAMA Network Open 2022, 5: e229953. PMID: 35503221, PMCID: PMC9066284, DOI: 10.1001/jamanetworkopen.2022.9953.Peer-Reviewed Original ResearchConceptsFirst acute myocardial infarctionAcute myocardial infarctionPsychosocial risk factorsRisk factor profilePopulation attributable fractionRisk factor associationsRisk factorsOdds ratioYoung womenAMI subtypesMyocardial infarctionPrevention of AMIType 1 acute myocardial infarctionFactor profileRisk of AMITraditional cardiovascular risk factorsSex-specific risk factorsFactor associationsYoung adultsRisk factor modificationCardiovascular risk factorsStrong associationNutrition Examination SurveyCase-control studyPopulation-based controls
2020
Sex Differences in Symptom Phenotypes Among Patients With Acute Myocardial Infarction
Brush JE, Krumholz HM, Greene EJ, Dreyer RP. Sex Differences in Symptom Phenotypes Among Patients With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2020, 13: e005948. PMID: 32063049, PMCID: PMC7041412, DOI: 10.1161/circoutcomes.119.005948.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBiological Variation, IndividualFemaleHealth Status DisparitiesHumansInterviews as TopicMaleMiddle AgedMyocardial InfarctionPatient AdmissionPhenotypePredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSex FactorsSpainSymptom AssessmentUnited StatesYoung AdultConceptsAcute myocardial infarctionMyocardial infarctionMedical recordsYoung womenDiagnosis of AMIObservational cohort studyMedical record abstractionSymptom phenotypeDiagnostic processAnalysis of symptomsVIRGO StudyCohort studyRecord abstractionIndividual patientsClinician's abilityDiagnosis rateStandardized interviewPhenotype subgroupsSymptomsSimilar findingsYoung adultsWomenMenInfarctionPatients
2019
Application of the VIRGO taxonomy to differentiate acute myocardial infarction in young women
Sciria CT, Dreyer RP, D'Onofrio G, Safdar B, Krumholz HM, Spatz ES. Application of the VIRGO taxonomy to differentiate acute myocardial infarction in young women. International Journal Of Cardiology 2019, 288: 5-11. PMID: 31031078, DOI: 10.1016/j.ijcard.2019.03.054.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseCardiac catheterizationYoung womenNon-obstructive coronary artery diseaseSingle-center retrospective chart reviewYoung AMI Patients (VIRGO) studyObstructive coronary artery diseaseRetrospective chart reviewAcute myocardial infarctionProportion of womenUniversal definitionIndex admissionChart reviewArtery diseaseConsecutive womenMyocardial infarctionTreatment strategiesCatheterizationMore young womenType 2Type 1Class IType 4BWomenPatient studies
2018
Sex 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 1
2017
Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain
Lindau S, Abramsohn E, Bueno H, D’Onofrio G, Lichtman J, Lorenze N, Sanghani R, Spatz E, Spertus J, Strait K, Wroblewski K, Zhou S, Krumholz H. Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain. Obstetrical & Gynecological Survey 2017, 72: 334-335. DOI: 10.1097/01.ogx.0000516136.75506.a3.Peer-Reviewed Original ResearchSex 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 OnsetBiomarkersC-Reactive ProteinChi-Square DistributionComorbidityFemaleHealth 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 preventionYoung Women With Acute Myocardial Infarction
Dreyer RP, Sciria C, Spatz ES, Safdar B, D'Onofrio G, Krumholz HM. Young Women With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003480. PMID: 28228455, PMCID: PMC5502480, DOI: 10.1161/circoutcomes.116.003480.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionYoung womenMyocardial infarctionManagement of AMIPost-AMI periodContinuum of careCoronary diseaseAged menHigh riskWorse recoveryWomenInfarctionHighlight gapsRecent studiesDifferent mechanismsMorbidityHospitalMortalityEpidemiologyPublic awarenessDiseaseDiagnosisCare
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 outcomesSexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain
Lindau ST, Abramsohn E, Bueno H, D’Onofrio G, Lichtman JH, Lorenze NP, Sanghani RM, Spatz ES, Spertus JA, Strait KM, Wroblewski K, Zhou S, Krumholz HM. Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain. JAMA Cardiology 2016, 1: 754-764. PMID: 27579897, PMCID: PMC5459405, DOI: 10.1001/jamacardio.2016.2362.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionSexual function problemsSexual activityMyocardial infarctionYoung AMI Patients (VIRGO) studyYoung womenSexual problemsModifiable risk factorsLogistic regression analysisMultinomial logistic regression analysisPrevalent sexual problemPhysician counselingMedian ageMost young adultsSexual functionRisk factorsSpanish hospitalsMAIN OUTCOMEErectile difficultiesFirst monthYoung adultsTime pointsWomenMore womenPatient studiesEditor’s Choice-Sex differences in young patients with acute myocardial infarction: A VIRGO study analysis
Bucholz EM, Strait KM, Dreyer RP, Lindau ST, D’Onofrio G, Geda M, Spatz ES, Beltrame JF, Lichtman JH, Lorenze NP, Bueno H, Krumholz HM. Editor’s Choice-Sex differences in young patients with acute myocardial infarction: A VIRGO study analysis. European Heart Journal Acute Cardiovascular Care 2016, 6: 610-622. PMID: 27485141, PMCID: PMC5459677, DOI: 10.1177/2048872616661847.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionYoung womenTime of AMIST-segment elevation myocardial infarctionHigh clinical risk scoreSegment elevation myocardial infarctionChronic obstructive pulmonary diseaseYoung AMI patientsCardiovascular risk factorsClinical risk scorePre-hospital delayProspective cohort studyCongestive heart failureElevation myocardial infarctionObstructive pulmonary diseaseHigh-risk populationYoung menMental health statusElectrocardiogram findingsMorbid obesityCardiovascular riskCohort studyRenal failureYounger patientsReturn 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
2015
The Variation in Recovery
Spatz ES, Curry LA, Masoudi FA, Zhou S, Strait KM, Gross CP, Curtis JP, Lansky AJ, Soares Barreto-Filho JA, Lampropulos JF, Bueno H, Chaudhry SI, D'Onofrio G, Safdar B, Dreyer RP, Murugiah K, Spertus JA, Krumholz HM. The Variation in Recovery. Circulation 2015, 132: 1710-1718. PMID: 26350057, PMCID: PMC4858327, DOI: 10.1161/circulationaha.115.016502.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge of OnsetAlgorithmsAortic DissectionClassificationCoronary DiseaseDiagnostic Techniques, CardiovascularFemaleHumansMaleMedical RecordsMiddle AgedMyocardial InfarctionMyocardiumOxygen ConsumptionPhenotypePlaque, AtheroscleroticProspective StudiesReproducibility of ResultsRisk FactorsSex FactorsTreatment OutcomeYoung AdultConceptsAcute myocardial infarctionCoronary artery diseaseArtery diseaseClinical phenotypeNonobstructive coronary artery diseaseYoung AMI Patients (VIRGO) studyObstructive coronary artery diseaseYoung womenType 2 acute myocardial infarctionBiological disease mechanismsSubset of patientsThird universal definitionUnique clinical phenotypeCulprit lesionClinical characteristicsMyocardial infarctionTherapeutic efficacyUniversal definitionStudy participantsPatientsSupply-demand mismatchYoung adultsDisease mechanismsPatient studiesCurrent classification schemesSex Differences in the Rate, Timing, and Principal Diagnoses of 30-Day Readmissions in Younger Patients with Acute Myocardial Infarction
Dreyer RP, Ranasinghe I, Wang Y, Dharmarajan K, Murugiah K, Nuti SV, Hsieh AF, Spertus JA, Krumholz HM. Sex Differences in the Rate, Timing, and Principal Diagnoses of 30-Day Readmissions in Younger Patients with Acute Myocardial Infarction. Circulation 2015, 132: 158-166. PMID: 26085455, PMCID: PMC5322973, DOI: 10.1161/circulationaha.114.014776.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionPrincipal diagnosisYounger patientsHigh riskUtilization Project State Inpatient DatabasesYoung womenCause readmission rateGreater mortality riskSex differencesNoncardiac diagnosesReadmission diagnosesReadmission timingReadmission ratesInpatient DatabaseReadmission riskFemale sexCondition categoriesReadmissionMortality riskHealthcare costsDay 2InfarctionPatientsDiagnosisFrequency and Effects of Excess Dosing of Anticoagulants in Patients ≤55 Years With Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention (from the VIRGO Study)
Gupta A, Chui P, Zhou S, Spertus JA, Geda M, Lorenze N, Lee I, Onofrio G, Lichtman JH, Alexander KP, Krumholz HM, Curtis JP. Frequency and Effects of Excess Dosing of Anticoagulants in Patients ≤55 Years With Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention (from the VIRGO Study). The American Journal Of Cardiology 2015, 116: 1-7. PMID: 25937348, PMCID: PMC4466069, DOI: 10.1016/j.amjcard.2015.03.032.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge DistributionAngioplasty, Balloon, CoronaryAnticoagulantsAntithrombinsBody Mass IndexCohort StudiesFemaleHemorrhageHeparinHirudinsHumansMaleMiddle AgedMyocardial InfarctionPeptide FragmentsPercutaneous Coronary InterventionPlatelet Glycoprotein GPIIb-IIIa ComplexPrevalenceRecombinant ProteinsRisk AssessmentRisk FactorsSex DistributionTreatment OutcomeUnited StatesConceptsPercutaneous coronary interventionGlycoprotein IIb/IIIa inhibitorsIIb/IIIa inhibitorsExcess dosingAcute myocardial infarctionCoronary interventionMultivariable analysisMyocardial infarctionUnderwent Percutaneous Coronary InterventionLower body weightOlder patientsYounger patientsUnfractionated heparinMedical recordsUnivariate analysisAnticoagulant agentsAnticoagulant drugsBody weightPatientsDosingYounger ageLogistic regressionYoung womenAnticoagulantsGender-based differencesDepressive Symptoms in Younger Women and Men With Acute Myocardial Infarction: Insights From the VIRGO Study
Smolderen KG, Strait KM, Dreyer RP, D'Onofrio G, Zhou S, Lichtman JH, Geda M, Bueno H, Beltrame J, Safdar B, Krumholz HM, Spertus JA. Depressive Symptoms in Younger Women and Men With Acute Myocardial Infarction: Insights From the VIRGO Study. Journal Of The American Heart Association 2015, 4: e001424. PMID: 25836055, PMCID: PMC4579927, DOI: 10.1161/jaha.114.001424.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionDepressive symptomsLifetime historyMyocardial infarctionRisk factorsYoung acute myocardial infarctionYoung AMI Patients (VIRGO) studyMore cardiovascular risk factorsYoung womenCardiovascular risk factorsTime of admissionAdverse medical outcomesMore depressive symptomsLow socioeconomic profileAMI severityVIRGO StudyCardiovascular riskChart abstractionYounger patientsClinical profileRelevant sex differencesPatient profilesAMI admissionsMedical outcomesPatientsSex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction
D'Onofrio G, Safdar B, Lichtman JH, Strait KM, Dreyer RP, Geda M, Spertus JA, Krumholz HM. Sex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction. Circulation 2015, 131: 1324-1332. PMID: 25792558, PMCID: PMC4652789, DOI: 10.1161/circulationaha.114.012293.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionMyocardial infarctionReperfusion therapyAcute ST-segment elevation myocardial infarctionProspective observational cohort studyYoung AMI Patients (VIRGO) studyTime guidelinesYoung womenObservational cohort studyProportion of patientsElevation myocardial infarctionPercutaneous coronary interventionYears of ageSex differencesPatients 18Reperfusion strategyCohort studyCoronary interventionFibrinolytic therapyNeedle timeYounger patientsReperfusion delayRatio of womenReperfusion guidelinesSex disparities
2014
Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010
Gupta A, Wang Y, Spertus JA, Geda M, Lorenze N, Nkonde-Price C, D'Onofrio G, Lichtman JH, Krumholz HM. Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010. Journal Of The American College Of Cardiology 2014, 64: 337-345. PMID: 25060366, PMCID: PMC4415523, DOI: 10.1016/j.jacc.2014.04.054.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionLength of stayHospital mortalityHospitalization ratesClinical characteristicsAge groupsAMI hospitalization ratesYounger patientsMyocardial infarctionLonger LOSNationwide Inpatient Sample dataYoung womenU.S. hospital dischargesPrevalence of comorbiditiesPrincipal discharge diagnosisNational Inpatient SampleSex differencesContemporary longitudinal dataLarge national datasetMore comorbiditiesHospital dischargeDischarge diagnosisInpatient SampleMortality rateAge 30
2013
Age and sex differences in inhospital complication rates and mortality after percutaneous coronary intervention procedures: Evidence from the NCDR®
Lichtman JH, Wang Y, Jones SB, Leifheit-Limson EC, Shaw LJ, Vaccarino V, Rumsfeld JS, Krumholz HM, Curtis JP. Age and sex differences in inhospital complication rates and mortality after percutaneous coronary intervention procedures: Evidence from the NCDR®. American Heart Journal 2013, 167: 376-383. PMID: 24576523, DOI: 10.1016/j.ahj.2013.11.001.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionComplication rateOlder womenPCI typeYoung womenInhospital mortalityMortality riskAge groupsElective percutaneous coronary interventionPercutaneous coronary intervention (PCI) proceduresInhospital complication rateRate of complicationsHigh complication rateRisk-adjusted analysisRisk-adjusted mortalityCoronary intervention proceduresUnadjusted complication rateSex-based differencesPCI patientsCathPCI RegistryCoronary interventionYounger patientsClinical factorsHospital admissionMore complications