Sex differences in medical care and early death after acute myocardial infarction.

Published

Journal Article

BACKGROUND: Women receive less evidence-based medical care than men and have higher rates of death after acute myocardial infarction (AMI). It is unclear whether efforts undertaken to improve AMI care have mitigated these sex disparities in the current era. METHODS AND RESULTS: Using the Get With the Guidelines-Coronary Artery Disease database, we examined sex differences in care processes and in-hospital death among 78 254 patients with AMI in 420 US hospitals from 2001 to 2006. Women were older, had more comorbidities, less often presented with ST-elevation myocardial infarction (STEMI), and had higher unadjusted in-hospital death (8.2% versus 5.7%; P<0.0001) than men. After multivariable adjustment, sex differences in in-hospital mortality rates were no longer observed in the overall AMI cohort (adjusted odds ratio [OR]=1.04; 95% CI, 0.99 to 1.10) but persisted among STEMI patients (10.2% versus 5.5%; P<0.0001; adjusted OR=1.12; 95% CI, 1.02 to 1.23). Compared with men, women were less likely to receive early aspirin treatment (adjusted OR=0.86; 95% CI, 0.81 to 0.90), early beta-blocker treatment (adjusted OR=0.90; 95% CI, 0.86 to 0.93), reperfusion therapy (adjusted OR=0.75; 95% CI, 0.70 to 0.80), or timely reperfusion (door-to-needle time

Full Text

Duke Authors

Cited Authors

  • Jneid, H; Fonarow, GC; Cannon, CP; Hernandez, AF; Palacios, IF; Maree, AO; Wells, Q; Bozkurt, B; Labresh, KA; Liang, L; Hong, Y; Newby, LK; Fletcher, G; Peterson, E; Wexler, L; Get With the Guidelines Steering Committee and Investigators,

Published Date

  • December 16, 2008

Published In

Volume / Issue

  • 118 / 25

Start / End Page

  • 2803 - 2810

PubMed ID

  • 19064680

Pubmed Central ID

  • 19064680

Electronic International Standard Serial Number (EISSN)

  • 1524-4539

Digital Object Identifier (DOI)

  • 10.1161/CIRCULATIONAHA.108.789800

Language

  • eng

Conference Location

  • United States