Quality of Care and 30-day Mortality of Women and Men With Acute Myocardial Infarction [Calidad del cuidado y mortalidad a 30 días de mujeres y varones con infarto agudo de miocardio]

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Araújo, C (Author) Other; Laszczy¿ska, O (Author) Other; Viana, M (Author) Other; Dias, P (Author) Other; Maciel MJ (Author) FMUP; Moreira, I (Author) Other; Azevedo A (Author) FMUP

Journal

Title: Revista Espanola de Cardiologia

ISSN: 0300-8932

Publisher: Elsevier

Indexing

Scopus - 8 Citations

Other information

Authenticus ID: P-00P-P1X

DOI: 10.1016/j.recesp.2018.05.016

Abstract (EN): Introduction and objectives: Despite increased awareness of sex disparities in care and outcomes of acute myocardial infarction (AMI), there appears to have been no consistent attenuation of these differences over the last decade. We investigated differences by sex in management and 30-day mortality using the European Society of Cardiology Acute Cardiovascular Care Association quality indicators (QIs) for AMI. Methods: Proportions and standard errors of the 20 Acute Cardiovascular Care Association QIs were calculated for 771 patients with AMI who were admitted to the cardiology departments of 2 tertiary hospitals in Portugal between August 2013 and December 2014. The association between the composite QI and 30-day mortality was derived from logistic regression. Results: Significantly fewer eligible women than men received timely reperfusion, were discharged on dual antiplatelet therapy and high-intensity statins, and were referred to cardiac rehabilitation. Women were less likely to receive recommended interventions (59.6% vs 65.2%; P <.001) and also had higher mean GRACE 2.0 risk score-adjusted 30-day mortality (3.0% vs 1.7%; P <.001). An inverse association between the composite QI and crude 30-day mortality was observed for both sexes (OR, 0.08; 95%CI, 0.01-0.64 for the highest performance tertile vs the lowest). Conclusions: Performance in AMI management is worse for women than men and is associated with higher 30-day mortality, which is also worse for women. Evidence-based QIs have the potential to improve health care delivery and patient prognosis in the overall AMI population and may also bridge the disparity gap between women and men. Full English text available from: www.revespcardiol.org/en © 2018 Sociedad Española de Cardiología

Language: English

Type (Professor's evaluation): Scientific