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Treatment of patients with acute myocardial infarction in relation to gender
B W Karlson1, M Hartford, J Herlitz
1Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Insights
This study found no significant differences in acute myocardial infarction (AMI) treatment or prognosis between men and women in the pre-thrombolytic era. Revascularization rates were similar, with minor variations in early medication use.
Area of Science:
- Cardiology
- Clinical Medicine
- Health Services Research
Background:
- Sex-based differences in acute myocardial infarction (AMI) treatment are debated.
- Understanding historical treatment patterns is crucial for evaluating current disparities.
Purpose of the Study:
- To compare pharmacological treatments and revascularization procedures between men and women hospitalized with AMI.
- To assess potential sex-based differences in AMI management during hospitalization and 1-year follow-up in the prethrombolytic era.
Main Methods:
- Retrospective analysis of 300 women and 621 men with AMI admitted in 1986-1987.
- Comparison of medication use (morphine, anticoagulants, diuretics) and revascularization procedures.
- Follow-up assessment at discharge and 1 year post-hospitalization.
Main Results:
- Men received higher doses of morphine and more frequently anticoagulants at discharge.
- Women were more likely to be prescribed diuretics at discharge and 1-year follow-up.
- No significant differences were observed in revascularization procedures between sexes.
Conclusions:
- While minor differences in early pharmacological management existed, no major treatment disparities impacting prognosis were identified between men and women with AMI in this prethrombolytic era study.
- Findings suggest comparable care regarding revascularization, but highlight potential sex-based variations in medication management.
- This study provides a historical benchmark for evaluating sex-based treatment differences in acute myocardial infarction.
Abstract:
The question whether women and men with acute myocardial infarction (AMI) are treated differently is currently debated. In this analysis we compared pharmacological treatments and revascularization procedures during hospitalization and during 1 year of follow-up in 300 women and 621 men who suffered an AMI in 1986 or 1987 at our hospital. During hospitalization, the mean dose of morphine (+/- SD) during the first 3 days was higher in men compared to women (14.5 +/- 15.7 vs. 9.8 +/- 10.3 mg, p < 0.001), more men than women were given morphine after the first 24 h (65.4 vs. 49.0%, p < 0.01), and more men were prescribed anticoagulants at discharge (18 vs. 12%, p < 0.05). After 1 year more women than men were on diuretics (61.3 vs. 42.8%, p < 0.001) and a similar observation was made at discharge. This study was performed before thrombolytic therapy was routinely used. The frequency of revascularization procedures did not differ between men and women during hospitalization or during the year of follow-up. In conclusion, no major treatment differences, which could affect the prognosis, were found between women and men hospitalized due to AMI in this study in the prethrombolytic era.