[Gender differences in early reperfusion treatment after myocardial infarction].
OBJECTIVE
Clinical variability in myocardial infarction (MI) regarding age, comorbidities and atypical symptoms could determine gender differences in inhospital care. This study analyzes the magnitude and determinants of differences between men and women in early reperfusion therapy in people hospitalized after MI.


METHODS
2,836 patients who arrived to hospital with MI were studied (IBERICA-Basque Country study). The relative risk (RR) of receiving early reperfusion for men versus women, adjusted by age, clinical characteristics, risk factors, and pre-hospital delay was estimated. The effect decomposition methodology and the log binomial regression were applied.


RESULTS
29% of patients were women with a median age of 77 years. The RR of revascularization in men compared to women was different according to age. When factors such as hypertension diabetes, Killip III-IV at admission and atypical symptoms were taken into account, statistically significant differences between sexes were not detected at 45 years old (RR=0.91; 95% CI=0.77-1.07). However, for 64 years old and over, the RR of reperfusion was 1.24 (95% CI=1.05-1.47). Both the differences by sex and the sex-age interaction were no longer statistically significant after adjusting by pre-hospital delay.


CONCLUSIONS
The delay to receive medical care in elderly women is responsible of gender differences in early reperfusion. It is necessary to analyze the reasons for treatment-seeking delay.
Aldasoro
Elena
E
Departamento de Sanidad, Gobierno Vasco, Spain. ealdasoro-san@ej.gv.es
Calvo
Montse
M
Esnaola
Santiago
S
Hurtado de Saracho
Iraida
I
Alonso
Eva
E
Audicana
Covadonga
C
Arós
Fernando
F
Lekuona
Iñaki
I
Arteagoitia
José M
JM
Basterretxea
Mikel
M
Marrugat
Jaime
J
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D015425:Myocardial Reperfusion / Q000706:statistics & numerical data*; D012737:Sex Factors; D013997:Time Factors