Key result
Female gender was associated with lower prescription rates of guideline-recommended drugs after a first acute myocardial infarction, including lipid-modifying agents.
Why the study?
Gender differences in pharmacological treatment after acute myocardial infarction have been reported, but real-world data evaluating gender differences in secondary prevention prescribing and initiation patterns and their explanatory factors were needed.
Are there gender differences in the prescribing patterns and initiation of guideline-recommended drugs after a first acute myocardial infarction?
Observational (n=3,975)
Are there gender differences in the prescribing patterns and initiation of guideline-recommended drugs after a first acute myocardial infarction?
Despite guidelines, women experience less therapeutic effort after a first AMI, being prescribed key secondary prevention drugs less frequently than men, largely driven by older age and higher morbidity burden.
Answers are grounded in this paper and cite their sources.
Sex differences in post-AMI prescribing may signal care gaps; hypothesis-generating and requires prospective validation before informing practice.
BACKGROUND: European guidelines recommend the prescription of certain drugs after acute myocardial infarction (AMI). The existence of gender differences in pharmacological treatment after an AMI has been described. This study aims to describe and analyse, using real-world data (RWD), whether there are gender differences in the prescribing patterns and initiation of treatment in secondary prevention after a first AMI, and which are the factors that explain these differences. METHODS: A population-based observational study of RWD was conducted in the CARhES (CArdiovascular Risk factors for hEalth Services research) cohort. The study included subjects who had experienced a first episode of AMI between 2017 and 2022, had survived the event, and had a minimum follow-up of 180 days. RESULTS: 3,975 subjects were followed 180 days after a first AMI. Women (27.8% of the study population) were older and had more comorbidities. Of the main guideline-recommended drugs, antiplatelets, lipid modifying agents and beta-blockers, were prescribed less often in women. Comedications such as rivaroxaban and calcium channel blockers were more likely to be prescribed in women. The proportion of subjects initiating treatment was similar in both genders. Overall, age and morbidity burden were the main contributors to differences in the prescribing patterns. Living in an urban area seemed to be a protective or mitigating factor. There were controversial results regarding socioeconomic level. CONCLUSION: In our study population, women are older, have greater comorbidities and lower socioeconomic status. Despite this, gender inequalities in the prescribing patterns after a first AMI remains, as women appear to experience less therapeutic effort. It is crucial to analyse them from an intersectional perspective, considering the influence of multiple axes of inequality on health, in order to develop gender-sensitive strategies with a multidisciplinary approach.
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López-Ferreruela et al. (2025) conducted an observational in Acute myocardial infarction (n=3,975). Female gender vs. Male gender was evaluated on Prescription of lipid modifying agents after a first AMI (p=<0.001). Female gender was associated with lower prescription rates of guideline-recommended drugs after a first acute myocardial infarction, including lipid-modifying agents.
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