Introduction:
There were inequalities in treatments prescribing to women resulted in poorer outcome in woman compare to men in many conditions include ST-elevation myocardial infarction (STEMI).
Hypothesis:
This study aims to described the difference of dual antiplatelet therapy (DAPT) prescription between gender and its effect on outcome.
Methods:
We conducted a retrospective study of consecutive patients presented with STEMI who underwent primary percutaneous coronary intervention at a tertiary care hospital in Thailand from January 2011 to December 2015. Patients’ baseline characteristics, usage of antiplatelet and mortality were collected. Chi-square and Log-rank were used to analyze.
Results:
Total of 755 patients (74.8% male) were included. Women were significantly older (68.1 ± 13.4 vs 57.6 ± 12.7, p <0.005), had lower hemoglobin at baseline (12 ± 1.9 vs 14.3 ± 2, p <0.005) and had more comorbidities include diabetes mellitus (46.6% vs 26.2%, p<0.005), hypertension (76.8% vs 49.2%, P<0.005) and chronic kidney disease (7.6% vs 3%, p=0.009). At the time of discharge, aspirin and clopidogrel were less commonly prescribed in women (86% vs 92.7%, p = 0.015 and 85.5% vs 91.1%, p=0.049, respectively) but the usage of DAPT was not statistically different between female and male (85.3% vs 90.9%, p=0.061) (Table). The 1-year survival is lower in women (79.5% vs 88.6%, p = 0.001). Patients who were discharged with DAPT had lower 1-year mortality than those without DAPT (2.6% vs 16.7%, p=0.003). Men, but not women, who were discharged with DAPT have the 1-year survival rate higher than those without DAPT.
Conclusions:
In conclusion, aspirin and clopidogrel but not DAPT were less commonly prescribed for women. The 1-year mortality was high in female which reflects the same disparity in outcomes that was found in western countries. There may be different effect of DAPT on males and female.
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