Abstract 11100: Persistent Gender Disparities in STEMI Mortality: Insights From the Midwest STEMI Consortium

Introduction: Over the past two decades, national and regional initiatives have been dedicated to closing the gender gap and resolving disparities in STEMI care and outcomes for females. In this study, we explored how gender disparities have evolved in a well-established regional STEMI system in the US. Methods: Using the Midwest STEMI Consortium database, we examined sex differences in STEMI treatment and outcomes when stratified by decade from 2003 to 2009 versus 2010 to 2020. Results: Among 12,878 consecutive STEMI patients, 30.3% were female. Females were older and more likely to have a history of hypertension and diabetes as compared to males in both time periods (2003-2009 and 2010-2020). Females persistently had longer door-to-balloon times, underwent less revascularization with PCI, and received GDMT less often than males in both time periods. From 2003 to 2009, the incidence of cardiogenic shock was higher in females. Despite improvements in the rate of in-hospital mortality in the last decade, the post-discharge to 1-year mortality risk was significantly higher in females compared to males in both time periods. Conclusions: Over the past two decades, gender disparities in STEMI care and outcomes have persisted. Despite an improvement in the rate of in-hospital mortality, sex differences persist with females having a higher risk of discharge to 1-year mortality. This is in part due to persistent discrepancies in baseline comorbidities and patient care, including longer door-to-balloon times and less GDMT at discharge. These findings underscore the need for both regional and national efforts to close this persistent gap.