title: Gender differences in the treatment of patients with acute myocardial infarction. A multihospital, community-based perspective.
abstract: OBJECTIVE
  As part of a community-wide study examining temporal trends in the incidence and survival rates of acute myocardial infarction, we examined differences between the sexes in overall utilization rates and changes over time, therein, of various therapies used in the management of acute myocardial infarction.
  
  
  METHODS
  Nonconcurrent prospective study.
  
  
  METHODS
  Three thousand three hundred sixty-one men and 2119 women hospitalized with validated acute myocardial infarction in 16 hospitals in the Worcester, Mass, metropolitan area during 1975, 1978, 1981, 1984, 1986, 1988, and 1990.
  
  
  RESULTS
  After controlling, by means of a logistic regression analysis, for a variety of patient-related factors that could affect physician prescribing patterns, women were significantly more likely to receive diuretics during hospitalization for acute myocardial infarction, whereas men were significantly more likely to receive antiplatelet agents, lidocaine, and other antiarrhythmic agents. No statistically significant differences were seen between men and women with regard to the use of anticoagulants, beta-blockers, calcium channel blockers, digoxin, nitrates, and thrombolytic agents. Marked increases over time (1975 through 1990) were seen in the use of anticoagulants, antiplatelet agents, beta-blockers, lidocaine, and nitrates in each of the sexes, while declines were seen in the use of digoxin and diuretics. Use of thrombolytic therapy increased between 1986 and 1990, whereas use of calcium channel blockers decreased over this period for both men and women.
  
  
  CONCLUSIONS
  The results of this multihospital, population-based, observational study suggest that physician practice patterns in the pharmacologic treatment of men and women hospitalized with acute myocardial infarction are very similar.
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester.
authors.forename: P R
authors.initials: PR
authors.lastname: Pagley
authors.forename: J
authors.initials: J
authors.lastname: Yarzebski
authors.forename: R
authors.initials: R
authors.lastname: Goldberg
authors.forename: Z
authors.initials: Z
authors.lastname: Chen
authors.forename: D
authors.initials: D
authors.lastname: Chiriboga
authors.forename: P
authors.initials: P
authors.lastname: Dalen
authors.forename: J
authors.initials: J
authors.lastname: Gurwitz
authors.forename: J S
authors.initials: JS
authors.lastname: Alpert
authors.forename: J M
authors.initials: JM
authors.lastname: Gore
mesh_terms: D000368:Aged; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012044:Regression Analysis; D012737:Sex Factors