학술논문
Abstract 15652: Gender Difference in Use of Acute Coronary Syndrome Medications and Outcomes at 6-months Post Discharge
Document Type
Academic Journal
Source
Circulation. Nov 14, 2017 136(Suppl_1 Suppl 1):A15652-A15652
Subject
Language
English
ISSN
0009-7322
Abstract
Introduction: Previous studies have shown that women with acute coronary syndrome (ACS) are less likely to receive in-hospital care such as revascularisation procedures and guideline-recommended medications. So, our aim was to find if the rate of medication use and outcomes also differ by gender in patients with ACS after discharge.Hypothesis: Women are less likely to take secondary prevention medication and have more major adverse cardiovascular events (MACE) and death than men.Methods: Of ACS patients recruited from 41 hospitals between February 2009 to September 2016, 7303 were discharged alive and followed up at 6-month post discharge as part of the Cooperative National Registry of Acute Coronary Care, Guideline Adherence and Clinical Events (CONCORDANCE) registry. Multivariable logistic regressions within the framework of generalized estimating equations were used to compare the rate of medication use, MACE (myocardial infarction, heart failure or stroke) and all-cause death within 6 months after discharge.Results: Of 7303 ACS patients, 2087 (29%) were women. Women had more comorbidities than men, however, women were less likely to take aspirin (76% vs 82%, <.001), other antiplatelet (55% vs 63%, <.001), beta blocker (62% vs 68%, <.001) and statin (78% vs 85%, <.001) compared to men. The proportion who were on >75% of secondary prevention medications at 6-month post discharge were lower in women than men (74% vs 80%, <.001). After adjusting for clinical characteristics, women had 14% lower odds of taking >75% of the medications than men (95% confidence interval: 0.76-0.97). Also, women had 35% greater odds of having a MACE compared to men (1.09-1.67). No difference in the odds of all-cause death was observed between women and men.Conclusions: Despite the awareness programs and campaigns that have been running to educate women to close the secondary prevention gap between women and men, our findings suggest that women take fewer secondary prevention medications and are more likely to have a secondary event.