Sex-related differences in non-ischemic myocardial injury in the emergency department: A real-world perspective

Int J Cardiol. 2024 Jan 15:395:131394. doi: 10.1016/j.ijcard.2023.131394. Epub 2023 Sep 23.

Abstract

Background: Myocardial injury is associated with adverse outcomes. No data are reported about sex differences in incidence and factors associated with myocardial injury in an emergency department (ED) setting from a real-world perspective. We aimed to assess whether sex plays a major role in the diagnosis of myocardial injury in the ED.

Methods: In this subanalysis of a retrospective study, patients presenting at the ED with at least one high-sensitivity cardiac troponin T (hs-cTnT) value and without acute coronary syndromes diagnosis were compared.

Results: 31,383 patients were admitted to the ED, 4660 had one hs-cTnT value, and 3937 were enrolled: 1943 females (49.4%) and 1994 males (50.6%). The diagnosis of myocardial injury was higher among men (36.8% vs. 32.9%, p < 0.01). Male sex was independently associated with myocardial injury. An older age, an elevated NT-proB-type Natriuretic Peptide and a lower estimated glomerular filtrate rate were independently associated with myocardial injury in both sexes.

Conclusions: In the ED, from a real-world perspective, myocardial injury occurred more frequently in males, and it was associated with older age and the presence of cardiac, lung, and kidney disease but not higher hs-cTnT values.

Keywords: Cardiac troponin; Emergency department; Gender differences; High sensitivity cardiac troponin; Myocardial injury; Risk factors.

MeSH terms

  • Acute Coronary Syndrome* / diagnosis
  • Acute Coronary Syndrome* / epidemiology
  • Biomarkers
  • Emergency Service, Hospital
  • Female
  • Heart Injuries* / diagnosis
  • Heart Injuries* / epidemiology
  • Humans
  • Male
  • Retrospective Studies
  • Sex Characteristics
  • Troponin T

Substances

  • Biomarkers
  • Troponin T