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Gender differences in the assessment and treatment of myocardial infarction
Jarle Jortveit1, Ragna Elise Støre Govatsmark2, Jørund Langørgen3
1Medisinsk avdeling Sørlandet sykehus, Arendal.
Insights
In Norway, women with myocardial infarction received less coronary angiography and secondary medication than men. Survival and complication rates were similar, suggesting potential gender bias in acute myocardial infarction care.
Area of Science:
- Cardiology
- Public Health
- Gender Studies in Medicine
Background:
- International guidelines recommend identical treatment for myocardial infarction (MI) in men and women.
- Previous studies indicate gender disparities in MI assessment and treatment.
- This study examines gender-based differences in MI care within Norway.
Purpose of the Study:
- To investigate gender-related differences in the assessment and treatment of myocardial infarction in Norway.
- To analyze variations in diagnostic procedures, interventions, complications, and survival between men and women.
- To identify potential contributing factors to observed gender disparities in MI management.
Main Methods:
- Retrospective analysis of data from the Norwegian Myocardial Infarction Registry (2013-2014).
- Inclusion of all patients admitted with myocardial infarction.
- Comparison of assessment, treatment, complications, and survival rates between genders and age groups.
Main Results:
- Fewer women than men underwent coronary angiography.
- Percutaneous coronary intervention (PCI) rates were similar for both genders when coronary stenosis was present.
- Women were less frequently recommended secondary prophylactic medication compared to men.
- No significant differences were observed in post-MI complications or survival rates between genders.
Conclusions:
- Gender-related disparities exist in the assessment and secondary medication recommendations for myocardial infarction patients in Norway.
- While diagnostic and treatment intensity (angiography) differed, outcomes like complications and survival were comparable.
- Potential reasons for these differences include comorbidity, adverse reaction risks in women, and physician perspectives, warranting further investigation.
Background:
Previous studies have shown that there are gender-related differences in the assessment and treatment of myocardial infarction, despite international guidelines that prescribe identical treatment for women and men. We investigated whether these differences occurred in Norway.
Material And Method:
All patients admitted to Norwegian hospitals with myocardial infarction from 1 January 2013 to 31 December 2014 and registered in the Norwegian Myocardial Infarction Registry were included. Data from the registry were used to analyse differences in the assessment, treatment, complications and survival of women and men in different age groups.
Results:
A total of 26 447 myocardial infarctions were registered in the Norwegian Myocardial Infarction Registry in the period 2013 – 2014. Fewer women than men were assessed by means of coronary angiography. Percutaneous coronary intervention (PCI) was used to virtually the same extent for both genders if coronary stenosis was found. Women were recommended secondary prophylactic medication to a lesser extent than men. There were no major differences between men and women in the incidence of complications in the course following myocardial infarction or in survival.
Interpretation:
Fewer women than men suffering acute myocardial infarction were assessed by means of coronary angiography, and women were recommended secondary prophylactic medication less often than men. The reason for the gender differences is not known, but comorbidity and a potentially greater risk of adverse reactions in women may be contributory factors. The different views of doctors providing treatment may also play a part.
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