A Global Systematic Review and Meta-Analysis of Sex Disparities in Outcomes in Patients with ST-segment Elevation Myocardial Infarction

Abstract Background Sex disparities in the delivery of care and in-hospital outcomes following ST-segment elevation myocardial infarction (STEMI) remain a global concern. We performed an updated global meta-analysis comparing clinical outcomes between males and females with STEMI. Methods This study was conducted according to PRISMA guidelines (PROSPERO CRD42024612510). We searched major electronic databases from 1 st January 2000 to 7 th November 2024. Pairwise meta-analysis was performed on outcomes related to time-to-therapy, in-hospital outcomes, and optimal therapy, with subgroup analyses of geographic regions. Meta-regression was performed to evaluate heterogeneity. Results A total of 69 studies, involving 891,585 patients (262,773 females; 628,401 males) were included. Males were younger (MD -7.387 years), less likely to have diabetes, hypertension, and prior stroke, had significantly lower risk of in-hospital mortality (RR 0.56, 95%CI 0.53 to 0.61, P