Women with acute coronary syndrome had significantly poorer adherence to lipid-lowering medication than men (OR 0.87), with no significant sex differences observed for other cardiovascular medications.
Meta-Analysis
Does female sex influence adherence to cardiovascular medications in patients after acute coronary syndrome compared to male sex?
Women with a history of acute coronary syndrome have significantly poorer adherence to lipid-lowering therapies compared to men, highlighting a sex disparity in secondary prevention.
Effect estimate: OR 0.87 (95% CI 0.82-0.92)
Absolute Event Rate: 73.6% vs 75.3%
Introduction: Pharmacological treatment is an important component of secondary prevention in acute coronary syndrome (ACS) survivors. However, adherence to medication regimens is often suboptimal, reducing the effectiveness of treatment. It has been suggested that sex influences adherence to cardiovascular medication, but results differ across studies, and a systematic overview is lacking. Methods: We performed a systematic search of PubMed and EMBASE on 16 October 2019. Studies that reported sex-specific adherence for one or more specific medication classes for ACS patients were included. Odds ratios, or equivalent, were extracted per medication class and combined using a random effects model. Results: In total, we included 28 studies of which some had adherence data for more than one medication group. There were 7 studies for angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) ( n = 100,909, 37% women), 8 studies for antiplatelet medication ( n = 37,804, 27% women), 11 studies for beta-blockers ( n = 191,339, 38% women), and 17 studies for lipid-lowering medication ( n = 318,837, 35% women). Women were less adherent to lipid-lowering medication than men (OR = 0.87, 95% CI 0.82–0.92), but this sex difference was not observed for antiplatelet medication (OR = 0.95, 95% CI 0.83–1.09), ACEIs/ARBs (OR = 0.95, 95% CI 0.78–1.17), or beta-blockers (OR = 0.97, 95% CI 0.86–1.11). Conclusion: Women with ACS have poorer adherence to lipid-lowering medication than men with the same condition. There are no differences in adherence to antiplatelet medication, ACEIs/ARBs, and beta-blockers between women and men with ACS.
Bots et al. (Mon,) conducted a meta-analysis in Acute coronary syndrome. Female sex vs. Male sex was evaluated on Good adherence to lipid-lowering medication (OR 0.87, 95% CI 0.82-0.92). Women with acute coronary syndrome had significantly poorer adherence to lipid-lowering medication than men (OR 0.87), with no significant sex differences observed for other cardiovascular medications.