Gender differences in case fatality rates of acute myocardial infarction in Serbia. (January 2014)

• Record Type: Journal Article
• Authors: Vasiljevic, Zorana; Krljanac, Gordana; Davidovic, Goran; Panic, Gordana; Radovanovic, Slavica; Mickovski, Natasa; Srbljak, Nebojsa; Markovic-Nikolic, Natasa; Curic-Petkovic, Slavenka; Panic, Milica; Cenko, Edina; Manfrini, Olivia; Martelli, Irene; Koller, Akos; Badimon, Lina; Bugiardini, Raffaele
• Is Part Of: European heart journal supplements. Volume 16(2014)Supplement A
• Page Start: A48
• Page End: A55
• Publication Date: 2014-01
• Subjects: Sex disparities -- Therapy -- Acute coronary syndrome -- Serbia; Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/sut012
• Languages: English
• ISSNs: 1520-765X

Abstract

Abstract: We sought to investigate sex differences in clinical characteristics, treatment and in in-hospital mortality in patients admitted with ST elevation myocardial infarction (STEMI) in Serbia. From October 2010 to September 2013, a total of 2348 patients have been hospitalized and received medical treatment for STEMI in 19 hospitals, referring data to the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC) registry. There were 773 women and 1575 men. Women were older than man, with a higher prevalence of family history of coronary artery disease, hypertension, and diabetes. They were less likely to be smokers and more likely to have a prior angina and history of heart failure. Fewer women than men presented within 2 h from symptom onset ( P = 0.005). They presented more with Killip class ≥2 than men ( P = 0.004). A significantly lower proportion of women was treated with aspirin (91.3% vs 94.3%, P = 0.007), clopidogrel (88% vs. 91%, P = 0.02), heparins (61.6% vs. 66.5%, P = 0.01) and primary percutaneous coronary interventions (62.1% vs. 69.7%, P < 0.001). The in-hospital mortality was significantly higher for women than for men (13.2% vs. 6.4%, P < 0.001). After adjustment for any confounders, women showed an increased risk of in-hospital mortality (odds ratio: 1.97, 95% confidence interval: 1.28–3.01, P = 0.002). Several factors contribute to the excess in-hospital case fatality rates in Serbian women. Most notably disparities in medical treatment appear to play a crucial role.