Women with STEMI were treated with DTB90 at a lower rate (51.7%) than men (56.9%), despite overall improvements in ACS performance measures over time.
Does female sex reduce the likelihood of receiving timely door-to-balloon times and early aspirin administration in patients with acute coronary syndrome?
Despite overall temporal improvements in acute coronary syndrome care, significant sex-based disparities persist, with women remaining less likely to receive timely reperfusion.
Absolute Event Rate: 0% vs 0%
Background Sex‐based differences in acute coronary syndrome (ACS) mortality may attenuate with age due to better symptom recognition and prompt care. Hypothesis Age is a modifier of temporal trends in sex‐based differences in ACS care. Methods Among 104 817 eligible patients with ACS enrolled in the AHA Get With the Guidelines–Coronary Artery Disease registry between 2003 and 2008, care and in‐hospital mortality were evaluated stratified by sex and age. Temporal trends within sex and age groups were assessed for 2 care processes: percentage of STEMI patients presenting to PCI‐capable hospitals with a DTB time ≤ 90 minutes (DTB90) and proportion of eligible ACS patients receiving aspirin within 24 hours. Results After adjustment for clinical risk factors and sociodemographic and hospital characteristics, 2276 (51.7%) women and 6276 (56.9%) men with STEMI were treated with DTB90 (adjusted OR: 0.85, 95% CI: 0.80–0.91, P < 0.0001 for women vs men). Time trend analysis showed an absolute increase ranging from 24% to 35% in DTB90 rates among both men and women ( P for trend <0.0001 for each group), with consistent differences over time across the 4 age/sex groups (3‐way P ‐interaction = 0.93). Despite high rate of baseline aspirin use (87%–91%), there was a 9% to 11% absolute increase in aspirin use over time, also with consistent differences across the 4 age/sex groups (all 3‐way P ‐interaction ≥0.15). Conclusions Substantial gains of generally similar magnitude existed in ACS performance measures over 6 years of study across sex and age groups; areas for improvement remain, particularly among younger women.
Udell et al. (Fri,) reported a other. Women with STEMI were treated with DTB90 at a lower rate (51.7%) than men (56.9%), despite overall improvements in ACS performance measures over time.