Gender Differences in the Treatment of Acute Coronary Syndromes: Results From the Epi-Cardio Registry

Javier Mariani, Laura Antonietti, Carlos Tajer, Maximiliano De Abreu, Adrián Charask, Mario Silberstein, Juan Gagliardi, Hernán Doval


BackgroundControversial evidence has been reported regarding gender bias in the managementof patients with acute coronary syndromes; thus, it is relevant to have data relatedto this topic in our country.ObjectiveThe aim of this study was to assess gender differences in the management of acutecoronary syndromes in cardiovascular care units participating in the Epi-Cardio registry.MethodsWe included 8997 records of patients with diagnosis of acute coronary syndromes.Propensity score adjusted analyses and sensitivity analysis were performed.ResultsIn patients with non ST-segment elevation acute coronary syndromes, women wereindependently associated with lower in-hospital indication of coronary angiography(OR 0.73, 95% CI 0.65 to 0.82), and lower use of IIb/IIIa inhibitors than men.After adjusted analyses, there were no significant differences between men andwomen in the use of reperfusion therapy for myocardial infarction or in in-hospitalmortality.At discharge, women were significantly less likely than men to receive prescriptionsfor beta-blockers and statins, and more likely to receive prescriptions for benzodiazepines.ConclusionsThese findings suggest gender bias in the treatment of patients with acute coronarysyndromes, evidenced by selection of a more conservative strategy and lower prescriptionof drugs recommended for secondary prevention in women. Differences betweengenders in the approach of acute coronary syndromes should be studied moredeeply, as the underutilization of evidence-based therapies could have an impact onwomen’s clinical outcomes.



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