Young women with acute MI less likely to receive, adhere to pharmacotherapy

Young women with acute MI are less likely than young men to use secondary prevention CV medications, according to study findings published in Circulation: Cardiovascular Quality and Outcomes.

“There are two possible reasons why women take fewer [CV] medications than men in an outpatient setting: It is either a consequence of physicians’ prescribing behavior or patients not taking their prescribing medication, or both,” Kate Smolina, PhD, postdoctoral fellow in pharmacoepidemiology and pharmaceutical policy at the Center for Health Services and Policy Research, University of British Columbia, Vancouver, Canada, said in a press release.

Smolina and colleagues conducted a retrospective, population-based cohort study incorporating data on health care, prescription drug use, sociodemographic factors and mortality among 8,478 men and 3,783 women admitted to hospitals in British Columbia from 2007 to 2009 with a primary diagnosis of acute MI. All evaluated patients had a length of stay between 1 day and 3 months for acute MI, survived for 1 year after discharge and did not reside in a long-term care facility.

The majority of acute MI survivors either discontinued treatment or did not consistently fill their prescription, and young women were less likely to be on optimal therapy by the end of 1 year postdischarge. The researchers suggested this outcome was driven by a disparity in treatment initiation rather than treatment adherence.

More than two-thirds of the acute MI survivors initiated treatment with ACE inhibitors, beta-blockers or statins within 2 months of discharge. However, only one-third of survivors filled all appropriate prescriptions for 1 year after discharge. Regardless of age, men and women similarly adhered to medication therapy within 1 year after discharge.

After adjustment for income, ethnicity, comorbidities, prior medication use and procedure type, men were more likely to initiate appropriate treatment compared with women in all age groups, especially those aged 20 to 54 years (adjusted OR = 1.38; 95% CI, 1.1-1.75) and those aged 55 to 64 years (adjusted OR = 1.38; 95% CI, 1.13-1.68). Men in the youngest age group were also more likely to be on optimal therapy 1 year after discharge (adjusted OR = 1.3; 95% CI, 1.03-1.63). No other differences were observed with regard to optimal therapy according to sex.

Smolina and colleagues said clinicians and patients may benefit from better education and awareness of undertreatment of younger women who experience an acute MI. They also recommended exploring standardization of discharge prescriptions.

“It is important for both physicians and patients to move away from the traditional thinking that heart disease is a man’s disease,” Smolina said in the release.  – by Trish Shea, MA

Disclosure: The study was supported by a grant from the Canadian Institutes of Health Research (CIHR). Smolina reports funding from a CIHR Banting Postdoctoral Fellowship. The other researchers report no relevant financial disclosures.

Source: www.healio.com