Care Pathways After Acute Myocardial Infarction: A Gender-Based Perspective

Background/Objectives: Secondary prevention after a first acute myocardial infarction (AMI) is crucial to reduce complications and improve long-term outcomes. Persistent gender inequalities in cardiovascular care suggest differences in post-AMI healthcare pathways between men and women. Understanding these trajectories could guide post-discharge clinical management, secondary prevention, and follow-up after acute myocardial infarction. This study aimed to describe healthcare pathways following a first AMI and explore gender inequalities within these trajectories. Methods: We conducted an observational, population-based study using real-world data (RWD) from the CARhES cohort. A total of 4298 individuals discharged alive after a first AMI between 2017 and 2022 were included. Healthcare trajectories during the 90 days following discharge were reconstructed across primary and specialised care, emergency services, and hospital admissions, and stratified by sex and the occurrence of clinical outcomes. Results: Post-AMI care pathways were highly heterogeneous. Although general practitioners often served as the first point of contact, most trajectories began in emergency departments. Patients with clinical outcomes showed higher healthcare utilisation. Women accessed primary care more frequently, whereas men showed greater use of specialised services and higher readmission rates, patterns that may reflect differences in follow-up strategies and clinical management during the early post-discharge period. Despite this variability, overall trajectories showed no significant sex-based differences. Conclusions: Post-AMI care pathways are complex and variable, with gender differences in patterns of service use. Women more often accessed scheduled care, while men relied more on emergency services. These findings highlight the need for gender-sensitive post-discharge follow-up to guide clinicians in secondary prevention strategies for AMI.