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 ResearchMeSH KeywordsFemaleHealth StatusHospitalizationHumansMaleMyocardial InfarctionRisk FactorsSex CharacteristicsSex FactorsConceptsAcute 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. hospitalsWomenInfarctionOutcomes
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 scoresSex 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
Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction
Nanna MG, Hajduk AM, Krumholz HM, Murphy TE, Dreyer RP, Alexander KP, Geda M, Tsang S, Welty FK, Safdar B, Lakshminarayan DK, Chaudhry SI, Dodson JA. Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005691. PMID: 31607145, PMCID: PMC6913190, DOI: 10.1161/circoutcomes.119.005691.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overComorbidityDisability EvaluationFemaleHealth Status DisparitiesHealthcare DisparitiesHumansLife StyleMaleMyocardial RevascularizationNon-ST Elevated Myocardial InfarctionPatient AdmissionPrevalenceProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocial Determinants of HealthST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionSex-based differencesPercutaneous coronary interventionFunctional impairmentOlder adultsHospital complicationsCoronary interventionOlder patientsCoronary diseaseMyocardial infarctionAge-related functional impairmentsAge-associated functional impairmentsLower ratesPrior coronary diseaseObstructive coronary diseaseProspective observational studyNSTEMI subgroupSTEMI subgroupUnderwent revascularizationAcute myocardialChest painClinical presentationAMI subgroupRisk factorsHigh prevalencePsychosocial Factors and Recovery After Acute Myocardial Infarction in Younger Women
Smolderen KG, Brush A, Dreyer RP. Psychosocial Factors and Recovery After Acute Myocardial Infarction in Younger Women. Current Cardiology Reports 2019, 21: 50. PMID: 31020453, DOI: 10.1007/s11886-019-1140-x.Peer-Reviewed Original ResearchConceptsYoung womenAMI outcomesAMI carePsychosocial factorsPsychosocial stressorsAcute myocardial infarction riskAcute myocardial infarctionMyocardial infarction riskPurpose of ReviewToPotential psychosocial factorsAMI riskMyocardial infarctionCare pathwayOutpatient careWorse outcomesAMI incidenceInfarction riskEquitable careMortality ratePsychosocial interventionsCareWomenOutcomesRiskIncidenceApplication 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 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 and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014
Angraal S, Khera R, Wang Y, Lu Y, Jean R, Dreyer RP, Geirsson A, Desai NR, Krumholz HM. Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014. Journal Of The American Heart Association 2018, 7: e009014. PMID: 30005557, PMCID: PMC6064835, DOI: 10.1161/jaha.118.009014.Peer-Reviewed Original ResearchConceptsCoronary artery bypassCABG utilizationArtery bypassUse of CABGService Medicare beneficiariesCalendar year trendsCABG mortalityUnderwent CABGReadmission ratesCABG proceduresWhite patientsBlack patientsPatient groupMedicare beneficiariesMedicare feeMortality rateCABGAnnual declineWomenRacial subgroupsRacial differencesGreater declineOutcomesPatientsSexPresentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study
Safdar B, Spatz ES, Dreyer RP, Beltrame JF, Lichtman JH, Spertus JA, Reynolds HR, Geda M, Bueno H, Dziura JD, Krumholz HM, D'Onofrio G. Presentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e009174. PMID: 29954744, PMCID: PMC6064896, DOI: 10.1161/jaha.118.009174.Peer-Reviewed Original ResearchConceptsMI-CAD patientsNonobstructive coronary arteriesMI-CADYounger patientsClinical profileCoronary arteryMyocardial infarctionTraditional cardiac risk factorsAcute myocardial infarction patientsCardiac risk factorsGestational diabetes mellitusMyocardial infarction patientsTimes higher oddsMINOCA patientsSAQ qualityVIRGO StudyClinical characteristicsHypercoaguable stateDiabetes mellitusObstructive diseaseClinical outcomesInfarction patientsRisk factorsMINOCAPsychosocial statusSex 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 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
Gender differences in physical activity following acute myocardial infarction in adults: A prospective, observational study
Minges KE, Strait KM, Owen N, Dunstan DW, Camhi SM, Lichtman J, Geda M, Dreyer RP, Bueno H, Beltrame JF, Curtis JP, Krumholz HM. Gender differences in physical activity following acute myocardial infarction in adults: A prospective, observational study. European Journal Of Preventive Cardiology 2016, 24: 192-203. PMID: 27885060, DOI: 10.1177/2047487316679905.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAustraliaCardiac RehabilitationChi-Square DistributionExerciseExercise TherapyFemaleHealth BehaviorHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedMyocardial InfarctionOdds RatioPatient ComplianceProspective StudiesRisk FactorsSex FactorsSpainTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsAcute myocardial infarctionPost-acute myocardial infarctionMyocardial infarctionPhysical activityRegular physical activity participationYoung AMI Patients (VIRGO) studyPhysical activity recommendationsAmerican Heart AssociationPhysical activity trajectoriesNon-white raceMyocardial infarction recoveryPhysical activity participationGender differencesHospital dischargeHeart AssociationLifestyle behaviorsActivity recommendationsObservational studyInfarctionAustralian hospitalsTargeted interventionsOne monthPatientsTime pointsLonger durationSex 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 careEditor’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 patientsSex 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 disparitiesPatients
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 schemesDepressive 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 outcomesPatients