Age and sex inequalities in the prescription of evidence-based pharmacological therapy following an acute coronary syndrome in Portugal: the EURHOBOP study

Pereira, Marta; Araújo, Carla; Dias, Paula; Lunet, Nuno; Subirana, Isaac; Marrugat, Jaume; Capewell, Simon; Bennett, Kathleen; Azevedo, Ana

doi:10.1093/eurheartj/eht308.p2518

Cited by 2 publications

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“…16 Lower IHD mortality among women is most likely explained by their better risk factor profile, even though there is evidence of higher in-hospital mortality after a cardiovascular event and lower access to evidence-based secondary prevention in women compared to men. 34 A recent study showed a trend towards smaller gender differences in discharge medications of patients admitted with acute coronary syndromes in Portugal, after adjusting for the potential confounding effects of age, comorbidities and contraindications, 35 which is also a possible explanation for the lower burden due to YLLs found among women. Moreover, women tend to adhere more strictly to their doctor's recommendations and to adopt behaviors that will reduce the risk of cardiovascular disease, 36 which may contribute to the results found.…”

Section: Figurementioning

confidence: 99%

Disability-adjusted life years lost due to ischemic heart disease in mainland Portugal, 2013

Henriques

Araújo

Viana

et al. 2017

Revista Portuguesa de Cardiologia (English Edition)

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Introduction and Objectives:Estimates of the burden of ischemic heart disease (IHD), including geographic differences, should support health policy decisions. We set out to estimate the burden of IHD in mainland Portugal in 2013 by calculating disability-adjusted life years (DALYs) and to compare this burden between five regions. Methods: Years of life lost (YLLs) were calculated by multiplying the number of IHD deaths in 2013 (Statistics Portugal) by the life expectancy at the age at which death occurred. Years lived with disability (YLDs) were computed as the number of cases of acute coronary syndrome, stable angina and ischemic heart failure multiplied by an average disability weight. Crude and age-standardized DALYs (direct method, Standard European Population) were calculated for mainland Portugal and for the Northern, Central, Lisbon, Alentejo and Algarve regions. Results: In 2013, 95 413 DALYs were lost in mainland Portugal due to IHD. YLLs accounted for 88.3% of the disease burden. Age-standardized DALY rates per 1000 population were higher in men than in women, across the entire country (8.9 in men; 3.4 in women) and within each region, ranging from 7.3 in the Northern and Central regions to 11.8 in the Algarve in men, and from 2.6 in the Northern region to 4.6 in Lisbon in women. Conclusions: Nearly 100 000 DALYs were lost to IHD in Portugal, mostly through early mortality. This study enables accurate comparisons with other countries and between regions; however, it highlights the need for population-based studies to obtain specific data on morbidity. PALAVRAS-CHAVEAnos de vida saudável perdidos; Doença isquémica do coração; Portugal Anos de vida saudável perdidos devido a doença isquémica do coração em Portugal continental em 2013Resumo Introdução e objetivos: A carga de doença atribuível à doença isquémica do coração (DIC), nomeadamente possíveis diferenças regionais, deve orientar políticas de saúde. Pretendemos estimar a carga de doença atribuível a DIC em Portugal continental em 2013, através do cálculo dos anos de vida saudável perdidos (DALY) e comparar estas estimativas entre regiões. Métodos: Calcularam-se os anos de vida perdidos (YLL) multiplicando o número de mortes por DIC em 2013 (Instituto Nacional de Estatística) pela esperança média de vida à idade da morte. Estimaram-se os anos vividos com incapacidade (YLD) através do número de casos de síndrome coronária aguda, angina estável e insuficiência cardíaca isquémica. Os DALY brutos e padronizados para a idade (método direto, população-padrão europeia) foram calculados para Portugal continental e para as regiões Norte, Centro, Lisboa, Alentejo e Algarve. Resultados: Em 2013, perderam-se 95 413 DALY em Portugal por DIC. Destes, 88,3% foram por morte prematura. A taxa de DALY perdidos por 1000 habitantes padronizada para a idade foi mais elevada nos homens em todo o país (8,9 nos homens; 3,4 nas mulheres) e em cada região, variando de 7,3 no Norte e Centro até 11,8 no Algarve nos homens, e de 2,6 no Norte a 4,6 em Lisboa nas mul...

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Section: Figurementioning

confidence: 99%

Disability-adjusted life years lost due to ischemic heart disease in mainland Portugal, 2013

Henriques

Araújo

Viana

et al. 2017

Revista Portuguesa de Cardiologia (English Edition)

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“…Similarly to our results, advanced age appeared as a negative predictor of the use of benefi cial therapy in both studies. Pereira et al (15) reported a decreased likelihood of patients aged ≥ 80 years after myocardial infarction with STsegment elevation to be prescribed aspirin or the combination of aspirin with clopidogrel at hospital discharge. In contrast to our results, age ≥ 65 years was correlated positively with the prescription of antiplatelet/anticoagulant drugs in the study of Filippi et al (11) who evaluated the secondary prevention in Italian stroke patients.…”

Section: Tab 2 the Univariate Analysis Of The Infl Uence Of Patientmentioning

confidence: 99%

“…However, patients with atrial fi brillation were not included in our study sample. Several studies evaluated the use of antiplatelet medication in elderly patients (14,15,19). Most of these studies were focused solely on patients with a condition of stroke or myocardial infarction.…”

Section: Tab 2 the Univariate Analysis Of The Infl Uence Of Patientmentioning

confidence: 99%

“…Since older patients are at increased risk of mortality, they could have a greater absolute benefi t from guideline-recommended therapies (9,10). Nevertheless, the underuse of benefi cial cardiovascular medication, such as antiplatelet agents, in elderly patients has been described in several studies (11)(12)(13)(14)(15). Underuse of antiplatelet medication in patients with established atherosclerotic disease of coronary or cerebral arteries is listed also in START criteria (Screening Tool to Alert Doctors to the Right Treatment) (16,17).…”

Section: Introductionmentioning

confidence: 99%

“…Studies, which evaluated the underuse of antiplatelet medication were focused mostly on a sole medical condition (myocardial infarction or stroke) (14,15,19). To our knowledge, there is no similar study, which evaluates and compares the effect of hospitalisation on the use of antiplatelet medication among patients after different thrombotic events, such as myocardial infarction or stroke/ TIA or both.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The use of antiplatelet medication in hospitalised elderly patients

Wawruch¹,

Slezakova²,

Murı́n³

et al. 2015

BLL

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BACKGROUND: The use of antiplatelet agents is strongly recommended for the secondary prevention of ischemic events such as myocardial infarction, stroke/transient ischemic attack (TIA). OBJECTIVES: The aim of our study was to analyse the use of antiplatelet medication in patients after myocardial infarction, stroke/TIA, and patients with both conditions and to identify patient-related characteristics, which determine the use of such drugs in elderly patients. METHODS: Study sample (n = 372) was derived from 2,157 patients admitted to long-term care departments of three municipal hospitals. The study included patients aged ≥65 years after myocardial infarction, stroke/TIA or both. RESULTS: Antiplatelet medications were prescribed in 54.8 % and 68.5 % of patients at hospital admission and discharge, respectively. Hospitalisation led to a signifi cant increase in the use of antiplatelet medication in patients after myocardial infarction and in those with the combination of both events. However, in patients after only stroke/TIA, we did not fi nd any signifi cant difference comparing the use of antiplatelet medication at the time of hospital admission and discharge, respectively. CONCLUSION: Our study revealed that physicians are more aware of the benefi ts of antiplatelet medication in elderly patients after myocardial infarction or those after both myocardial infarction and stroke/TIA in comparison with patients after only stroke/TIA (Tab. 3, Ref. 32). Text in PDF www.elis.sk.

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Age and sex inequalities in the prescription of evidence-based pharmacological therapy following an acute coronary syndrome in Portugal: the EURHOBOP study

Cited by 2 publications

References 0 publications

Disability-adjusted life years lost due to ischemic heart disease in mainland Portugal, 2013

Disability-adjusted life years lost due to ischemic heart disease in mainland Portugal, 2013

The use of antiplatelet medication in hospitalised elderly patients

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