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

pp. 277-278

Abstract

Background. Controversial evidence has been reported regarding gender bias in the management of patients with acute coronary syndromes; thus, it is relevant to have data related to this topic in our country.

Objective. The aim of this study was to assess gender differences in the management of acute coronary syndromes in cardiovascular care units participating in the Epi-Cardio registry.

Methods. We included 8997 records of patients with diagnosis of acute coronary syndromes. Propensity score adjusted analyses and sensitivity analysis were performed.

Results. In patients with non ST-segment elevation acute coronary syndromes, women were independently 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 and women in the use of reperfusion therapy for myocardial infarction or in in-hospital mortality. At discharge, women were significantly less likely than men to receive prescriptions for beta-blockers and statins, and more likely to receive prescriptions for benzodiazepines.

Conclusions. These findings suggest gender bias in the treatment of patients with acute coronary syndromes, evidenced by selection of a more conservative strategy and lower prescription of drugs recommended for secondary prevention in women. Differences between genders in the approach of acute coronary syndromes should be studied more deeply, as the underutilization of evidence-based therapies could have an impact on women’s clinical outcomes.