Sex differences in Quality of Life in Patients with Ischemia with No Obstructive Coronary Artery Disease (INOCA): A Patient Self-Report Retrospective Survey from INOCA International

Women with obstructive coronary artery disease (CAD) have a relatively lower quality of life (QoL) compared to men, but our understanding of sex differences in QoL in ischemia with no obstructive coronary artery disease (INOCA) is limited. We conducted a survey of patient members of INOCA International with an assessment of self-reported health measures. Functional capacity was retrospectively estimated using the Duke Activity Status Index (DASI), assessing levels of activities performed before and after INOCA symptom onset. Of the 1579 patient members, the overall survey completion rate was 21%. Women represented 91% of the respondents. Estimated functional capacity, expressed as metabolic equivalents (METs), was higher before compared to after INOCA diagnosis comparably for both women and men. For every one MET decline in functional capacity, there was a significantly greater decline in QoL for men compared with women in physical health (4.0 ± 1.1 vs. 2.9 ± 0.3 days/month, p < 0.001), mental health (2.4 ± 1.2 vs. 1.8 ± 0.3 days/month, p = 0.001), and social health/recreational activities (4.1 ± 1.0 vs. 2.9 ± 0.3 days/month, p = 0.0001), respectively. In an international survey of patients living with INOCA, despite similar diagnoses, clinical comorbidities, and symptoms, INOCA-related functional capacity declines are associated with a greater adverse impact on QoL in men compared to women

NATIONWIDE EVALUATION OF REVASCULARIZATION INEQUALITIES ASSOCIATED WITH STEMI AND COVID-19 IN THE UNITED STATES

Therapeutic AreaASCVD/CVD in Special Populations BackgroundThe impact of the COVID-19 pandemic on potential racial disparities in ST-segment elevation myocardial infarction (STEMI) treatment is still unclear. We investigated various revascularization methods for STEMI patients, such as percutaneous coronary intervention (PCI), fibrinolytic therapy, and coronary artery bypass grafting (CABG), during the pandemic's initial nine months. Our study compared patients with and without COVID-19 and further stratified the data to assess potential differences based on race. MethodsWe identified all patients hospitalized for STEMI in 2020 using the National Inpatient Sample (NIS), identifying those with or without concurrent COVID-19. Logistic and linear regression was used for analyses of associations, with adjustment for potential confounders. ResultsAfter accounting for confounding factors, patients with both STEMI and COVID-19 had lower odds of PCI (aOR 0.73, 95% CI 0.58-0.91) and higher odds of undergoing thrombolytic therapy (aOR 3.23, 95% CI 1.69-6.14). In contrast, the odds of receiving either PCI or thrombolytic therapy were lower (aOR 0.77, 95% CI 0.62-0.96) for these patients compared to those diagnosed with STEMI without COVID-19 (Figure 1). Black and Asian/Pacific Islander patients had significantly lower odds of receiving PCI compared to White patients, with aORs of 0.83 (95% CI 0.58-0.90) and 0.78 (95% CI 0.66-0.90), respectively. Furthermore, Black patients were less likely to undergo coronary artery bypass grafting (CABG) surgery compared to White patients (aOR 0.68, 95% CI 0.53-0.87) (Table 1). ConclusionsOur research uncovered lower revascularization rates for COVID-19 patients with STEMI and identified notable racial disparities affecting Black and Asian/Pacific Islander patients. To foster health equity, it is imperative to implement urgent and targeted measures that address these disparities, such as increasing access to healthcare and fostering a culturally sensitive care environment