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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
  • Hoa L. Nguyen, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
  • Joel M. Gore, University of Massachusetts Medical School
  • 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 School
  • Ann L. Quill, University of Massachusetts Medical School
  • Frederick A. Anderson, Jr., University of Massachusetts Medical School
Student Author(s)
Hoa L. Nguyen
UMMS Affiliation
Graduate School of Biomedical Sciences, Clinical and Population Health Research Program
Date
9-26-2010
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
Citation Information
Hoa L. Nguyen, Robert J. Goldberg, Joel M. Gore, Keith A. A. Fox, et al.. "Age and sex differences, and changing trends, in the use of evidence-based therapies in acute coronary syndromes: perspectives from a multinational registry." Vol. 21 Iss. 6 (2010) ISSN: 1473-5830
Available at: http://works.bepress.com/robert_goldberg/295/