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Do women with acute myocardial infarction receive the same treatment as men?
K W Clarke1, D Gray, N A Keating
1University Hospital, Nottingham.
Objective:
To determine whether women with acute myocardial infarction in the Nottingham health district receive the same therapeutic interventions as their male counterparts.
Design:
Retrospective study.
Setting:
University and City Hospitals, Nottingham.
Patients:
All patients admitted with a suspected myocardial infarction during 1989 and 1990.
Main Outcome Measures:
Route and timing of admission to hospital, ward of admission, treatment, interventions in hospital, and mortality.
Results:
Women with myocardial infarction took longer to arrive in hospital than men. They were less likely to be admitted to the coronary care unit and were therefore also less likely to receive thrombolytic treatment. They seemed to have more severe infarcts, with higher Killip classes, and had a slightly higher mortality during admission. They were less likely than men to receive secondary prophylaxis by being discharged taking beta blockers or aspirin.
Conclusions:
Survival chances both in hospital and after discharge in women with acute myocardial infarction are reduced because they do not have the same opportunity for therapeutic intervention as men.