Younger men were 38% more likely than younger women to initiate appropriate treatment after AMI, with no significant difference in adherence.
Does sex disparity exist in the initiation and adherence to secondary prevention cardiovascular medications in survivors of acute myocardial infarction?
Women under 55 years are significantly less likely to be on optimal secondary prevention therapy 1 year post-AMI, driven by disparities in treatment initiation rather than adherence.
Absolute Event Rate: 0% vs 0%
Background— The prevalence of the use of secondary prevention cardiovascular medications is lower among women than men, but it is unclear if this is a result of lower treatment initiation among women or lower treatment adherence. We aimed to map the treatment pathway for survivors of acute myocardial infarction (AMI) by sex and age. Methods and Results— This retrospective population-based cohort study used linked administrative data sets in British Columbia (2004–2011), which include health care, prescription drugs, sociodemographic, and mortality information. The study cohort included all individuals admitted to hospital for AMI in 2007–2009 and survived for 1 year after hospital discharge. Patients were evaluated for whether they initiated and then subsequently filled prescriptions angiotensin-converting enzyme inhibitors, β-blockers, and statins. More than two thirds of AMI survivors initiated treatment on all appropriate medications, given their contraindications, within 2 months of discharge. Younger men were significantly more likely than younger women to initiate appropriate treatment (adjusted odds ratio, 1.38; 95% confidence interval, 1.10–1.75). By the end of 1 year after discharge, only one third of all AMI survivors filled all appropriate prescriptions for at least 80% of the year. There was no significant difference in adherence to medication therapy between women and men. Conclusions— The majority of AMI survivors either discontinue treatment or do not refill their prescriptions consistently. Women <55 years are significantly less likely to be on optimal therapy by the end of 1 year after discharge, which is driven by a sex disparity in treatment initiation and not treatment adherence.
“Medical adherence is important and difficult to achieve for many patients, and even more so for women compared to men. We should always be asking about medical adherence after ACS, especially among our patients with socioeconomic barriers to care, and discussing with them how we can help them be ...”
Smolina et al. (Wed,) reported a other. Younger men were 38% more likely than younger women to initiate appropriate treatment after AMI, with no significant difference in adherence.