Gender-related differences in reperfusion treatment allocation and outcome for acute myocardial infarction

Vacek, James L.; Handlin, Larry R.; Rosamond, Thomas; Beauchamp, Gary D.

doi:10.1016/s0002-9149(99)80070-8

Cited by 21 publications

(8 citation statements)

References 24 publications

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“…335 These observations have been documented in other regions of the world 337-344 as well as in Canada and the United States (Table 13). However, there are also data suggesting no sex bias in treatment allocation 345 and overall rates of reperfusion once they are adjusted for various clinical factors. 343,344 Women have also been observed to consume more hospital resources than men.…”

Section: Acute Myocardial Infarctionmentioning

confidence: 99%

A comprehensive view of sex-specific issues related to cardiovascular disease

Pilote¹,

Dasgupta²,

Guru³

et al. 2007

Canadian Medical Association Journal

374

256

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A comprehensive view of sex-specific issues related to cardiovascular disease Cardiovascular disease (CVD) is the leading cause of mortality in women. In fact, CVD is responsible for a third of all deaths of women worldwide and half of all deaths of women over 50 years of age in developing countries. The prevalence of CVD risk factor precursors is increasing in children. Retrospective analyses suggest that there are some clinically relevant differences between women and men in terms of prevalence, presentation, management and outcomes of the disease, but little is known about why CVD affects women and men differently. For instance, women with diabetes have a significantly higher CVD mortality rate than men with diabetes. Similarly, women with atrial fibrillation are at greater risk of stroke than men with atrial fibrillation. Historically, women have been underrepresented in clinical trials. The lack of good trial evidence concerning sex-specific outcomes has led to assumptions about CVD treatment in women, which in turn may have resulted in inadequate diagnoses and suboptimal management, greatly affecting outcomes. This knowledge gap may also explain why cardiovascular health in women is not improving as fast as that of men. Over the last decades, mortality rates in men have steadily declined, while those in women remained stable. It is also becoming increasingly evident that gender differences in cultural, behavioural, psychosocial and socioeconomic status are responsible, to various degrees, for the observed differences between women and men. However, the interaction between sex-and gender-related factors and CVD outcomes in women remains largely unknown. CMAJ 2007;176(6):S1-44 Although cardiovascular disease (CVD) is common, significant sex-related differences in its epidemiology have only recently been appreciated. The objective of this section is to demonstrate that there are sex-specific differences in the prevalence, complications and burden of CVD in terms of mortality, hospital admissions and quality of life. Abstract Search strategyA MEDLINE search was conducted using the MeSH terms "cardiovascular disease" OR "atrial fibrillation" OR "congestive heart failure." A second search used the terms "prevalence" OR "incidence" OR "mortality" and the final search combined the results of the first 2 searches and added the terms "gender" OR "sex." Articles identified in this manner were retrieved and their reference lists searched for additional relevant articles. The search was limited to English-language publications, but no other restrictions were applied. Other data sources included Web sites of the World Health Organization, the Canadian Institute for Health Information and the National Centre for Health Statistics. Thirty-three original studies were reviewed. Studies were included if they were cohort studies, case-control studies or nested cohort studies that examined the incidence, prevalence or mortality of CVD, congestive heart failure or atrial fibrillation. The studies had to include data on both ...

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Section: Acute Myocardial Infarctionmentioning

confidence: 99%

A comprehensive view of sex-specific issues related to cardiovascular disease

Pilote¹,

Dasgupta²,

Guru³

et al. 2007

Canadian Medical Association Journal

374

256

View full text Add to dashboard Cite

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“…However, multiple prior studies of ACS care overall, and those considering sex or race differences in care specifically, have shown a linkage of processes of care to clinical outcomes and quality of care. 3,6,7,11,12,14,18,19,28,29,[33][34][35][36][37] We cannot fully determine from this study how many of the OOH patients with chest pain had symptoms that were cardiac in nature. Despite this limitation, it is important to note that OOH chest pain protocols are designed to be used for patients with chest pain without objective proof of ACS.…”

Section: Limitationsmentioning

confidence: 99%

Influence of Sex on the Out‐of‐hospital Management of Chest Pain

Meisel

Armstrong

Mechem

et al. 2010

Academic Emergency Medicine

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“…In studies of gender differences in cardiac care using data up to 1995, many investigators reported significantly higher intervention rates for males than females (Ayanian and Epstein 1991;udvarhelyi et al 1992;Every et al 1993;Chiriboga et al 1993;Jaglal et al 1994;Kostis et al 1994;vacek et al 1995;Kudenchuk et al 1996;Woods et al 1998;de gevigney et al 2001), although some reported no difference after controlling for age (steingart et al 1991;Krumholz et al 1992;maynard et al 1992;funk and griffey 1994;vacek et al 1995;Wong et al 1998). Almost all newer studies show that gender differences are non-significant or marginal after controlling for age (Hanratty et al 2000;gottlieb et al 2000;Rathore et al 2002Rathore et al , 2003Khaykin et al 2002;Bertoni et al 2004;Pilote et al 2004;Bakler et al 2004;Williams et al 2004;moriel et al 2005;vaccarino et al 2005).…”

Section: Comparisons With Other Studiesmentioning

confidence: 99%

“…However, the results from a number of those studies (steingart et al 1991;maynard et al 1992;Krumholz et al 1992;funk and griffey 1994;shin et al 1999;Hanratty et al 2000;gottlieb et al 2000;Alter et al 2002;Heer et al 2002;Bertoni et al 2004;shaw et al 2004;Bakler et al 2004;Williams et al 2004;vaccarino et al 2005), along with others (vacek et al 1995;Khaykin et al 2002;Rathore et al 2003;Pilote et al 2004;moriel et al 2005), show that when patient age is adequately controlled for, the apparent gender difference is often diminished or becomes statistically non-significant. The current uncertainty is most pronounced for bypass surgery rates, for which some investigators report no gender difference after controlling for age, clinical characteristics or both (steingart et al 1991; maynard et al 1992; funk and griffey 1994; Kostis et al 1994;gottlieb et al 2000;ghali et al 2002), while others report that rates among males remain higher than those for females even after adjustment (Ayanian and Epstein 1991;udvarhelyi et al 1992;Krumholz et al 1992;Jaglal et al 1994;Woods et al 1998;de gevigney et al 2001;Rathore et al 2003;Bertoni et al 2004;shaw et al 2004;vaccarino et al 2005;Blomkalns et al 2005;Pilote et al 2004;fang and Alderman 2006).…”

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confidence: 99%

Age Difference Explains Gender Difference in Cardiac Intervention Rates After Acute Myocardial Infarction

Fransoo

Martens²,

Prior³

et al. 2010

hcpol

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many investigators have reported higher rates of cardiac procedures for males than females after acute myocardial infarction (AmI), suggesting that men are treated more aggressively than women. However, others have reported no significant differences after controlling for age, resulting in uncertainty about the existence of a true gender bias in cardiac care. In this study, a population-based cohort approach was used to calculate age-specific procedure rates by sex from administrative data. Chi-square tests and generalized linear modelling were used to assess gender differences and interactions. for all four procedures studied, rates were significantly higher for males than females (p<0.01). However, age-specific rates revealed few significant differences by gender and a sharp decrease in intervention rates with age for both males and females. generalized linear modelling confirmed that patient age was a significant predictor of intervention rates, whereas sex was not. The significant gender difference in overall rates was completely confounded by the older age profile of female AmI patients compared to their male counterparts. RésuméPlusieurs chercheurs ont observé de plus haut taux d'interventions cardiaques pour les hommes que pour les femmes après un infarctus aigu du myocarde (IAm), laissant

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Gender-related differences in reperfusion treatment allocation and outcome for acute myocardial infarction

Cited by 21 publications

References 24 publications

A comprehensive view of sex-specific issues related to cardiovascular disease

A comprehensive view of sex-specific issues related to cardiovascular disease

Influence of Sex on the Out‐of‐hospital Management of Chest Pain

Age Difference Explains Gender Difference in Cardiac Intervention Rates After Acute Myocardial Infarction

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