Sex Differences in Statin Treatment after Myocardial Infarction in Denmark: A Time-Trend Study Utilising Danish
Anna Sofia Vestergaard Andersen1,2, Shaun Theodor Florentz Sødergren3,4, Daniel Modin1,2
1Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark.
Introduction:
Sex differences in treatment with Statins after Myocardial Infarction (MI) are widely recognised. This study aimed to assess differences in statin treatment initiation after MI by sex, age groups, and year of MI.
Method:
We conducted a cohort study in Denmark using registries for patients with a first-time MI between 1st January 2000 and 31st December 2024, excluding patients already treated with lipid lowering drugs up to 180 days before their MI. Descriptive statistics and multivariable Poisson regression were used to explore the effect of sex on treatment initiation.
Results:
A total of 154,591 patients were included in the study (37% females, median age 75 years for females and 65 years for men). Overall, 54% of females versus 72% of males had initiated statin treatment within 180 days (p < .001). For females ≥40 years, significantly lower proportions were found in every year interval (p < .001 for all). Within the age groups, the relative difference between the sexes increased from 2000-2002 until 2015-2019, whereafter a decrease was found from 2015-2019 to 2020-2024, except among 60-69-year-olds for whom the decrease began earlier, starting in 2010-2014. Females had a 25% lower relative risk (RR 0.75 [0.74;0.76]) of initiating treatment. These differences remained after adjusting for age groups and year interval (RR 0.87 [0.86;0.87]) and after further adjustment for baseline characteristics (RR 0.91 [0.85;99]).
Conclusion:
A smaller proportion of females received statins than males after a MI. Disparities in treatment persisted over the years.
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