Care Pathways After Acute Myocardial Infarction: A Gender-Based Perspective

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Secondary prevention after acute myocardial infarction (AMI) is vital for reducing complications and improving long-term outcomes.
• Existing gender inequalities in cardiovascular care suggest potential differences in post-AMI healthcare pathways for men and women.
• Understanding these trajectories is essential for optimizing post-discharge clinical management and secondary prevention strategies.

Purpose of the Study:

• To describe healthcare pathways following a first AMI.
• To explore potential gender inequalities within these post-discharge trajectories.
• To inform tailored secondary prevention and follow-up care after AMI.

Main Methods:

• An observational, population-based study using real-world data (RWD) from the CARhES cohort.
• Inclusion of 4298 individuals discharged alive after a first AMI (2017-2022).
• Reconstruction of 90-day post-discharge healthcare trajectories across primary care, specialized care, emergency services, and hospital admissions, stratified by sex and clinical outcomes.

Main Results:

• Post-AMI care pathways exhibited significant heterogeneity, often initiating in emergency departments despite general practitioner contact.
• Patients experiencing clinical outcomes demonstrated higher healthcare utilization.
• Women accessed primary care more frequently, whereas men utilized specialized services more and had higher readmission rates, indicating potential sex-based differences in follow-up and management.

Conclusions:

• Post-AMI care pathways are complex and variable, with discernible gender-based differences in service utilization patterns.
• Women tended to access scheduled care more, while men more frequently utilized emergency services.
• Findings underscore the necessity for gender-sensitive post-discharge follow-up to refine secondary prevention strategies for AMI patients.