Abstract 4184: Gender Difference in Utilization of Secondary Preventive Measures in Patients with CAD
Background: Previous studies have suggested that women with cardiovascular disease may receive less aggressive care compared to men. Using a cardiology database from a tertiary referral center, we sought to determine if treatment difference still persist in the current era.
Methods: 2462 patients who were referred for secondary prevention to Preventive Cardiology Clinic at The Cleveland Clinic between 1997 to 2004 were analyzed. The primary objective was to analyze utilization of effective secondary preventive therapies as stated by ACC/AHA guideline such as ASA, statin, B- blocker, or ACE inhibitor use between gender. Multivariate logistic regression analysis was performed to assess the independent effect of gender on all cause mortality.
Results: Women were older (62.2 ± 11.1 vs. 59.4 ± 11.0, p<0.001) and more likely to be hypertensive (68.1% vs. 56.1%, p<0.001) than their male counterparts. However, they had similar rates of diabetes, smoking, and peripheral vascular disease. Overall, women were more likely to present with statistically higher baseline CRP (6.1 vs. 4.9 p<0.001), LDL (135 vs. 116, p<0.001), HDL (52 vs. 41, p<0.001), total cholesterol (238 vs. 202, p<0.001) than their male counterparts. Women were less likely to be on antiplatelet therapy (76.6 % vs. 85.0%, p<0.001) and statins or any lipid lowering therapy (62.6% vs. 67.1%, p=0.04) compared to men on presentation. There was a trend toward higher all-cause mortality in women compared to men (21.5% vs. 17.8%, p=0.09) at 7 years.
Conclusion: Even in the current era, women continue to receive less aggressive care compared to men. More efforts should be made to bridge the treatment gap between men and women.