10779/rcsi.10773227.v1
Frank Doyle
Frank
Doyle
Davida De La Harpe
Davida
De La Harpe
Hannah McGee
Hannah
McGee
Emer Shelley
Emer
Shelley
Ronán Conroy
Ronán
Conroy
Gender differences in the presentation and management of acute coronary syndromes: a national sample of 1365 admissions
Royal College of Surgeons in Ireland
2019
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
Psychology and Cognitive Sciences not elsewhere classified
2019-11-22 15:40:47
Journal contribution
https://repository.rcsi.com/articles/journal_contribution/Gender_differences_in_the_presentation_and_management_of_acute_coronary_syndromes_a_national_sample_of_1365_admissions/10773227
<p>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.</p>