TY - JOUR
T1 - Association between Gender, Process of Care Measures, and Outcomes in ACS in India
T2 - Results from the Detection and Management of Coronary Heart Disease (DEMAT) Registry
AU - Pagidipati, Neha J.
AU - Huffman, Mark D.
AU - Jeemon, Panniyammakal
AU - Gupta, Rajeev
AU - Negi, Prakash
AU - Jaison, Thannikot M.
AU - Sharma, Satyavan
AU - Sinha, Nakul
AU - Mohanan, Padinhare
AU - Muralidhara, B. G.
AU - Bijulal, Sasidharan
AU - Sivasankaran, Sivasubramonian
AU - Puri, Vijay K.
AU - Jose, Jacob
AU - Reddy, K. Srinath
AU - Prabhakaran, Dorairaj
PY - 2013/4/24
Y1 - 2013/4/24
N2 - Background:Studies from high-income countries have shown that women receive less aggressive diagnostics and treatment than men in acute coronary syndromes (ACS), though their short-term mortality does not appear to differ from men. Data on gender differences in ACS presentation, management, and outcomes are sparse in India.Methods and Results:The Detection and Management of Coronary Heart Disease (DEMAT) Registry collected data from 1,565 suspected ACS patients (334 women; 1,231 men) from ten tertiary care centers throughout India between 2007-2008. We evaluated gender differences in presentation, in-hospital and discharge management, and 30-day death and major adverse cardiovascular event (MACE; death, re-hospitalization, and cardiac arrest) rates. Women were less likely to present with STEMI than men (38% vs. 55%, p<0.001). Overall inpatient diagnostics and treatment patterns were similar between men and women after adjustment for potential confounders. Optimal discharge management with aspirin, clopidogrel, beta-blockers, and statin therapy was lower for women than men, (58% vs. 65%, p = 0.03), but these differences were attenuated after adjustment (OR = 0.86 (0.62, 1.19)). Neither the outcome of 30-day mortality (OR = 1.40 (0.62, 3.16)) nor MACE (OR = 1.00 (0.67, 1.48)) differed significantly between men and women after adjustment.Conclusions:ACS in-hospital management, discharge management, and 30-day outcomes did not significantly differ between genders in the DEMAT registry, though consistently higher treatment rates and lower event rates in men compared to women were seen. These findings underscore the importance of further investigation of gender differences in cardiovascular care in India.
AB - Background:Studies from high-income countries have shown that women receive less aggressive diagnostics and treatment than men in acute coronary syndromes (ACS), though their short-term mortality does not appear to differ from men. Data on gender differences in ACS presentation, management, and outcomes are sparse in India.Methods and Results:The Detection and Management of Coronary Heart Disease (DEMAT) Registry collected data from 1,565 suspected ACS patients (334 women; 1,231 men) from ten tertiary care centers throughout India between 2007-2008. We evaluated gender differences in presentation, in-hospital and discharge management, and 30-day death and major adverse cardiovascular event (MACE; death, re-hospitalization, and cardiac arrest) rates. Women were less likely to present with STEMI than men (38% vs. 55%, p<0.001). Overall inpatient diagnostics and treatment patterns were similar between men and women after adjustment for potential confounders. Optimal discharge management with aspirin, clopidogrel, beta-blockers, and statin therapy was lower for women than men, (58% vs. 65%, p = 0.03), but these differences were attenuated after adjustment (OR = 0.86 (0.62, 1.19)). Neither the outcome of 30-day mortality (OR = 1.40 (0.62, 3.16)) nor MACE (OR = 1.00 (0.67, 1.48)) differed significantly between men and women after adjustment.Conclusions:ACS in-hospital management, discharge management, and 30-day outcomes did not significantly differ between genders in the DEMAT registry, though consistently higher treatment rates and lower event rates in men compared to women were seen. These findings underscore the importance of further investigation of gender differences in cardiovascular care in India.
UR - http://www.scopus.com/inward/record.url?scp=84876564843&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0062061
DO - 10.1371/journal.pone.0062061
M3 - Article
C2 - 23637963
AN - SCOPUS:84876564843
SN - 1932-6203
VL - 8
JO - PloS one
JF - PloS one
IS - 4
M1 - e62061
ER -