Title

Age and sex differences, and changing trends, in the use of evidence-based therapies in acute coronary syndromes: perspectives from a multinational registry.

Authors

Hoa L. Nguyen, University of Massachusetts Medical SchoolFollow
Robert J. Goldberg, University of Massachusetts Medical SchoolFollow
Joel M. Gore, University of Massachusetts Medical SchoolFollow
Keith A. A. Fox, Royal Infirmary of Edinburgh
Kim A. Eagle, University of Michigan Health System
Enrique P. Gurfinkel, Dante Pazzanese Institute of Cardiology
Frederick A. Spencer, McMaster University
George W. Reed Ph.D., University of Massachusetts Medical SchoolFollow
Ann L. Quill, University of Massachusetts Medical School
Frederick A. Anderson Jr., University of Massachusetts Medical SchoolFollow

Student Author(s)

Hoa L. Nguyen

UMMS Affiliation

Graduate School of Biomedical Sciences, Clinical and Population Health Research Program

Publication Date

2010-09-26

Document Type

Article

Medical Subject Headings

Acute Coronary Syndrome; Evidence-Based Medicine; Disease Management; Sex Factors; Age Factors

Abstract

BACKGROUND: A limited number of studies have examined the age and sex differences, and potentially changing trends, in cardiac medication and procedure use in patients hospitalized with an acute coronary syndrome (ACS).

METHODS: Using data from a large multinational study, we examined the age and sex differences, and changing trends (1999-2007) therein, in the hospital use of evidence-based therapies in patients hospitalized with an ACS using data from the Global Registry of Acute Coronary Events (n=50 096).

RESULTS: After adjustment for several variables, in comparison with men below 65 years, patients in other age-sex strata had a significantly lower odds of receiving aspirin [odds ratios (ORs) for men 65-74, 75-84, and >/=85 years, women <65, 65-74, 75-84, and >/=85 years were 0.86, 0.84, 0.72, 0.80, 0.86, 0.68 and 0.46, respectively], angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ORs, 1.08, 1.01, 0,71, 0.83, 0.90, 0.89, and 0.63), beta blockers (ORs, 0.66, 0.52, 0.53, 0.67, 0.54, 0.53, and 0.52), statins (ORs, 0.72, 0.49, 0.29, 0.82, 0.68, 0.44, and 0.22), and undergoing coronary artery bypass graft surgery or a percutaneous coronary intervention (ORs, 0.79, 0.53, 0.21, 0.64, 0.57, 0.38, and 0.13) during their acute hospitalization. Age and sex differences in the receipt of these therapies remained relatively unchanged during the period under study.

CONCLUSION: Although there were increasing trends in the use of evidence-based medications and cardiac procedures over time, important gaps in the utilization of effective cardiac treatment modalities persist in elderly patients and younger women.

Rights and Permissions

Citation: Coron Artery Dis. 2010 Sep;21(6):336-44.

Related Resources

Link to article in PubMed

PubMed ID

20661139

Repository Citation

Nguyen HL, Goldberg RJ, Gore JM, Fox KA, Eagle KA, Gurfinkel EP, Spencer FA, Reed GW, Quill AL, Anderson FA. (2010). Age and sex differences, and changing trends, in the use of evidence-based therapies in acute coronary syndromes: perspectives from a multinational registry.. Clinical & Population Health Research. Retrieved from https://escholarship.umassmed.edu/gsbs_cphr/36