Sex differences in quality indicator attainment for myocardial infarction: a nationwide cohort study

Review of 691 290 acute MI hospitalisations in England and Wales (2003 – 2013) found that women less frequently received guideline-indicated care and had significantly higher mortality than men. An estimated 8243 deaths among women could have been prevented.

The findings demonstrate that compared to men, women received less:

• timely reperfusion therapy for STEMI (76.8% vs 78.9%; p<0.001),
• timely coronary angiography for non-STEMI (24.2% vs 36.7%; p<0.001),
• dual antiplatelet therapy (75.4% vs 78.7%) and secondary prevention therapies (87.2% vs 89.6% for statins, 82.5% vs 85.6% for ACE inhibitor/angiotensin receptor blockers and 62.6% vs 67.6% for beta-blockers; all p<0.001).

 

Median 30-day Global Registry of Acute Coronary Events risk score adjusted mortality was higher for women than men (5.2% vs 2.3% ; p<0.001).