Acute Disease, Adult, Age Factors, Aged, Aged 80 and over, Angioplasty Transluminal Percutaneous Coronary, Biological Markers/blood, Cholesterol/blood, Coronary Artery Bypass, Coronary Disease/diagnosis, Coronary Disease/epidemiology, Coronary Disease/therapy, Cross-Sectional Studies, Female, Humans, Insurance Health, Ireland/epidemiology, Male, Middle Aged, Myocardial Infarction/diagnosis, Myocardial Infarction/epidemiology, Myocardial Infarction/therapy, Myocardial Reperfusion, Platelet Aggregation Inhibitors/therapeutic use, Sex Factors, Syndrome
Department of Health and Children.
Background Gender differences in presentation and management of acute coronary syndromes (ACS) are well established internationally. This study investigated differences in a national Irish sample. Design Cross-sectional survey. Methods All centres (n= 39) admitting cardiac patients to intensive/coronary care provided information on 25 consecutive acute myocardial infarction patients and other ACS patients admitted concurrently (n= 1365 episodes). Patient data was analyzed in terms of those with prior ACS/revascularization, and those without. Results Men with prior established ACS/revascularization were twice as likely to have received revascularization procedures (coronary artery bypass graft or percutaneous coronary intervention) prior to admission when controlling for age, total cholesterol and insurance status [odds ratio (OR) 1.97, 95% confidence interval (CI) 1.18–3.29, P = 0.011]. No gender differences were seen in acute-phase reperfusion (OR 0.96, 95% CI 0.76–1.24, P >0.05) or antiplatelet therapy (OR 0.99, 95% CI 0.69–1.41, P > 0.05). For patients with prior ACS/revascularization, men were twice as likely to receive statins on discharge after adjustment for age and total cholesterol (OR 1.94, 95% CI 1.02–3.71, P= 0.045). Conclusions Women were treated differently to men. Fewer women with a positive history of ACS received revascularization prior to current admission and fewer women were prescribed lipid-lowering medications on discharge. Acute phase hospital treatment was not gender determined. These findings have implications for secondary prevention in Ireland.
Epidemiology | Psychology
Doyle F, De La Harpe D, McGee H, Shelley E, Conroy R. Gender differences in the presentation and management of acute coronary syndromes: a national sample of 1365 admissions. European Journal of Cardiovascular Prevention and Rehabilitation. 2005;12(4):376-9
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