Sex differences in the prevalence of coronary artery aneurysms and mortality among those with the disease among hospitalized patients in the United States, 2016 to 2018 Open Access

Minhas, Sheharyar (Fall 2021)

Permanent URL: https://etd.library.emory.edu/concern/etds/70795893q?locale=en
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Abstract

Coronary artery aneurysms (CAAs) are rare and often discovered incidentally during coronary angiography or other cardiac imaging.  There are no known differences in CAA prevalence across age groups; however, possible sex differences remain unclear.  Accordingly, we investigated possible sex differences in CAA prevalence and of all-cause mortality among CAA patients.  We conducted a cross-sectional analysis of publicly available, de-identified, 2016 to 2018 data from approximately 8 million inpatients in the United States multi-center National Inpatient Sample (NIS) database.  Our primary exposure of interest was sex.  We also included data on age, race, income, hospital division, and diagnoses of hyperlipidemia, diabetes mellitus, and hypertension as potential confounding and effect-modifying variables.  A total of 7,326,573 individual inpatients (3,174,632 male and 4,151,941 female), of whom 607 (0.008%, or 8.3/100,000) had a CAA diagnosis (427 male [0.013%], 180 [0.004%] female), were included for analysis.  Overall, cases were more likely to be male (70.4% vs. 43.3%; P<0.0001).  In the multivariable analysis, females relative to males, had less than half the odds of having a CAA diagnosis:  odds ratio (OR) 0.40; 95% confidence interval (CI) 0.33-0.48.  Among patients with a CAA diagnosis, there were 24 deaths (14 among males, and 10 among females).  The adjusted association of sex (females relative to males) with all-cause mortality among CAA patients was not statistically significant (OR 1.38; 95% CI 0.50-3.77).  In conclusion, our findings taken together with those of previous studies, suggest that men are more likely to be diagnosed with CAA than are women.

Table of Contents

Table of Contents

I.       BACKGROUND (CHAPTER I)…………………………………………………………..….1

II.     MANUSCRIPT (CHAPTER II)…………………………………………………………..…..5

1.     Abstract…………………………………………………………………………………..5

2.     Introduction……………………………………………………………………………....6

3.     Materials and Methods……………………………………….…………………………..8

a.     Data source and study population………………………………….…………….8

b.     Outcomes…………………………………………………………………………8

c.     Exposures……………………………………………………..…………………..9

d.     Statistical analysis…………………………………………………………...…..10

4.     Results…………………………………………………………………………………..11

a.     Patient characteristics……………………………….………………………….11

b.     Association of sex with CAA…………………………………………………..11

c.     Association of demographic/medical factors with CAA, by sex………………12

d.     Association of sex with all-cause mortality among CAA cases……………….12

5.     Discussion………………………………………………………………………..……12

III.   SUMMARY (CHAPTER III)….………………………………………………………….17

IV.  REFERENCES…………………………………………………………………………….19

V.    TABLES……………………………………………………………………………………24

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