[Gender bias in women with myocardial infarction: ten years after].
OBJECTIVE
Previous studies show that the women with acute myocardial infarction (AMI) receive less fibrinolitic treatment than the men. The objective of this study is to analyze if it exists any difference in fibrinolysis related to gender and to compare the results with those obtained 10 years ago.


METHODS
Retrospective descriptive study that compare patients with AMI of less than 24 hours of evolution of studies Analysis of Delay in Acute Infarct of Myocardium (ARIAM) in 2003-2004 and Project of Analysis Epidemiologist of Critical Patient (PAEEC) of 1992-1993.


METHODS
ICUs from 86 hospitals in Spain that participated in the PAEEC study and 120 ICUs in the ARIAM.


METHODS
We compared data of 9,981 patients including in study ARIAM in 2003-2004 with 1,668 of the PAEEC of 1992-1993.


RESULTS
Women were less likely to receive thrombolytic therapy than men (odds ratio= 0.82, p < 0.01), after adjusting for age, origin, size of the hospital and antecedents. The probability of fibrynolisis is lower in elderly, patients referred from the general ward, in hospitals of more than 1,000 beds and patients with arterial hypertension, stroke, diabetes or peripheral vascular disease. The probability of fibrinólisis is higher when patient is transferred from another hospital (followed by those of Emergencies Room), in the hospitals by less than 300 beds (followed by those of 300-1,000) and when history of prior ischemic heart disease exists. Comparing the two periods, has increased the frequency of fibrynolisis in both genders, although the increment has been greater in the women.


CONCLUSIONS
The women with AMI continue receiving less fibrynolisis, although exists an increase in the number of treatments superior to register in the men.
Servicio de Medicina Intensiva. Hospital de Sagunto. Valencia. España. calvo_reg@gva.es
R
R
Calvo-Embuena
C
C
González-Monte
J
J
Latour-Pérez
J
J
Benítez-Parejo
V
V
Lacueva-Moya
M J
MJ
Broch-Porcar
S
S
Ferrandis-Badía
V
V
López-Camps
V
V
Parra-Rodríguez
E
E
Gómez-Martínez
M A
MA
García-García
D
D
Arizo-León
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000706:statistics & numerical data; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D015897:Comorbidity; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006742:Hospital Bed Capacity; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery / Q000628:therapy; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D011287:Prejudice; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*
D005343:Fibrinolytic Agents
Desigualdad de esfuerzo terapéutico en mujeres con infarto agudo de miocardio: 10 años después.