A higher burden of metabolic risk factors and underutilization of therapy among women compared to men might influence a poorer prognosis: a study among acute myocardial patients in Albania, a transitional country in Southeastern Europe

S. Myftiu, E. Sulo, G. Burazeri, I. Sharka, A. Shkoza, G. Sulo

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Aim To determine the clinical profile, burden of risk factors, and quality of care among patients hospitalized for an acute myocardial infarction (AMI) with special focus on gender differences.

Methods The study included 256 AMI patients admitted to the Coronary Care Unit of "Mother Teresa" hospital in Tirana during 2013-2014. We obtained information on patients' demographic data, AMI characteristics, complications (heart failure [HF] and ventricular fibrillation [VF]), risk factors and medication use prior and during the AMI hospitalization. Age-adjusted Poisson regression analyses were applied to explore gender differences (women vs men) with regard to clinical profile and quality of care and results are expressed as incidence rate ratios (IRR).

Results 55.4% of patients had >= 3 risk factors, 44.5% developed HF, and 5.7% developed VF. Only 40.4% of patients received all 4 medication classes (beta-blockers, angiotensin-converting-enzyme inhibitor/angiotensin receptor blockers, statins, and aspirin) and 46.4% had revascularization. Significantly more women than men were obese, (P = 0.042) had diabetes, (P = 0.001) developed HF (P <0.001) or experienced a VF episode (P <0.001). After adjusting for age, differences with regard to obesity (IRR = 2.17; 95% confidence interval [CI] 1.154.09), diabetes (IRR = 1.35; 95% CI 1.07-1.71), HF (IRR = 1.32; 95% CI 1.02-1.74) and VF (IRR = 2.82; 95% CI 1.07-7.43) remained significant. There were no differences with regard to individual drug classes taken. However, women had fewer revascularization procedures than men (IRR = 0.65; 95% CI 0.43-0.98).

Conclusion Women were found to have more unfavorable clinical profile, higher complication rates, and underutilization of therapy, which may be influenced by socioeconomic differences between genders and lead to a differential prognosis.

Original languageEnglish
Pages (from-to)542-549
Number of pages8
JournalCroatian Medical Journal
Volume56
Issue number6
DOIs
Publication statusPublished - Dec 2015

Keywords

  • CORONARY-HEART-DISEASE
  • CARDIOVASCULAR-DISEASE
  • SEX-DIFFERENCES
  • EPIDEMIOLOGIC UPDATE
  • MORTALITY
  • FAILURE
  • TRENDS
  • REGISTRY
  • OBESITY
  • AGE

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