Abstract 12712: Gender Disparities in the Management and In-Hospital Outcomes Acute Myocardial Infarction: Temporal Changes Between 2006 and 2008. Insights from the Euro Heart Survey ACS III registry
Background: Gender differences in the quality of care in acute myocardial infarction (AMI) are related to the higher age and greater frequency of comorbidities in women as compared with men. Based on data from the Euro Heart Survey on Acute Coronary Syndromes (ACS) III, we assessed gender differences in treatment of ACS in Europe, and temporal changes over the two years of the survey.
Methods. In eligible patients with acute myocardial infarction, the rate of reperfusion, coronary angiography, use of aspirin, clopidogrel, betablockers, angiotensin converting enzyme inhibitors (ACEI) (in patients with left ventricular ejection fraction <0.40) and statins during acute phase and at discharge were recorded in EHS-ACSIII. Gender differences and changes between 2006 and 2008 were assessed after adjustment for co-morbidities and conditions at admission.
Results. Among all patients included in the survey, 11,478 were admitted in centers who participated regularly in the EHS-ACSIII over the 2 years (8854 with STEMI, and 7688 with NSTEMI). Women were less frequently treated with reperfusion, aspirin, clopidogrel, statins and coronary angiography. Between 2006 and 2008, the differences in reperfusion, aspirin and coronary angiography between genders became non significant. Conversely, aspirin, clopidogrel and statins remained statistically significantly less frequently used in women at discharge, suggesting awareness of a higher bleeding risk in women among physicians.
Conclusions. A gender difference was observed in the use of aspirin, clopidogrel, statins, reperfusion and coronary angiography. Over the two years of the survey, an increase in the quality of care was observed in both genders, with a reduction in the gender difference in the acute management, but not in the prescription at discharge of aspirin, clopidogrel and statins.
- © 2011 by American Heart Association, Inc.