Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries.

Autor: Hellgren T; Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Nobels väg 6, Sweden., Blöndal M; Department of Cardiology, Heart Clinic, Tartu University Hospital, 8 L. Puusepa Street, Estonia., Jortveit J; Department of Cardiology, Sorlandet Hospital, Arendal, Norway., Ferenci T; John von Neumann Faculty of Informatics, Obuda University, 1034 Budapest, Hungary., Faxén J; Department of Cardiology, Karolinska University Hospital, Eugeniavagen 23, 17165 Stockholm, Sweden., Lewinter C; Department of Cardiology, Karolinska University Hospital, Eugeniavagen 23, 17165 Stockholm, Sweden., Eha J; Department of Cardiology, Heart Clinic, Tartu University Hospital, 8 L. Puusepa Street, Estonia., Lõiveke P; Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia., Marandi T; Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia., Ainla T; Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia., Saar A; Centre of Cardiology, North Estonia Medical Centre, 19 J. Sutiste Street, 13419 Tallinn, Estonia., Veldre G; Department of Cardiology, University of Tartu, 8 L. Puusepa Street, 50406 Tartu, Estonia., Andréka P; Hungarian Myocardial Infarction Registry, Gottsegen Hungarian Institute of Cardiology, Budapest, Hungary., Halvorsen S; Department of Cardiology, Oslo University Hospital Ulleval, Oslo and University of Oslo, Kirkeveien 166, 0450 Oslo, Norway., Jánosi A; Hungarian Myocardial Infarction Registry, Gottsegen Hungarian Institute of Cardiology, Budapest, Hungary., Edfors R; Bayer AG, Cardiovascular Studies & Pipeline, Pharmaceuticals, Building S102, 13342 Berlin, Germany.
Jazyk: angličtina
Zdroj: European heart journal open [Eur Heart J Open] 2022 Jul 02; Vol. 2 (4), pp. oeac042. Date of Electronic Publication: 2022 Jul 02 (Print Publication: 2022).
DOI: 10.1093/ehjopen/oeac042
Abstrakt: Aims: Data on how differences in risk factors, treatments, and outcomes differ between sexes in European countries are scarce. We aimed to study sex-related differences regarding baseline characteristics, in-hospital managements, and mortality of ST-elevation myocardial infarction (STEMI) patients in different European countries.
Methods and Results: Patients over the age of 18 with STEMI who were treated in hospitals in 2014-17 and registered in one of the national myocardial infarction registers in Estonia ( n  = 5817), Hungary ( n  = 30 787), Norway ( n  = 33 054), and Sweden ( n  = 49 533) were included. Cardiovascular risk factors, hospital treatment, and recommendation of discharge medications were obtained from the infarction registries. The primary outcome was mortality, in-hospital, after 30 days and after 1 year. Logistic and cox regression models were used to study the associations of sex and outcomes in the respective countries. Women were older than men (70-78 and 62-68 years, respectively) and received coronary angiography, percutaneous coronary intervention, left ventricular ejection fraction assessment, and evidence-based drugs to a lesser extent than men, in all countries. The crude mortality in-hospital rates (10.9-15.9 and 6.5-8.9%, respectively) at 30 days (13.0-19.9 and 8.2-10.9%, respectively) and at 1 year (20.3-28.1 and 12.4-17.2%, respectively) after hospitalization were higher in women than in men. In all countries, the sex-specific differences in mortality were attenuated in the adjusted analysis for 1-year mortality.
Conclusion: Despite improved awareness of the sex-specific inequalities on managing patients with acute myocardial infarction in Europe, country-level data from this study show that women still receive less guideline-recommended management.
(© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze: MEDLINE
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