Association between gender, process of care measures, and outcomes in ACS in India: results from the detection and management of coronary heart disease (DEMAT) registry

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 sp...

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Veröffentlicht in:PloS one 2013-04, Vol.8 (4), p.e62061-e62061
Hauptverfasser: Pagidipati, Neha J, Huffman, Mark D, Jeemon, Panniyammakal, Gupta, Rajeev, Negi, Prakash, Jaison, Thannikot M, Sharma, Satyavan, Sinha, Nakul, Mohanan, Padinhare, Muralidhara, B G, Bijulal, Sasidharan, Sivasankaran, Sivasubramonian, Puri, Vijay K, Jose, Jacob, Reddy, K Srinath, Prabhakaran, Dorairaj
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container_title PloS one
container_volume 8
creator Pagidipati, Neha J
Huffman, Mark D
Jeemon, Panniyammakal
Gupta, Rajeev
Negi, Prakash
Jaison, Thannikot M
Sharma, Satyavan
Sinha, Nakul
Mohanan, Padinhare
Muralidhara, B G
Bijulal, Sasidharan
Sivasankaran, Sivasubramonian
Puri, Vijay K
Jose, Jacob
Reddy, K Srinath
Prabhakaran, Dorairaj
description 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. 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
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Data on gender differences in ACS presentation, management, and outcomes are sparse in India. 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&lt;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. 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. 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Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pagidipati, Neha J</au><au>Huffman, Mark D</au><au>Jeemon, Panniyammakal</au><au>Gupta, Rajeev</au><au>Negi, Prakash</au><au>Jaison, Thannikot M</au><au>Sharma, Satyavan</au><au>Sinha, Nakul</au><au>Mohanan, Padinhare</au><au>Muralidhara, B G</au><au>Bijulal, Sasidharan</au><au>Sivasankaran, Sivasubramonian</au><au>Puri, Vijay K</au><au>Jose, Jacob</au><au>Reddy, K Srinath</au><au>Prabhakaran, Dorairaj</au><au>Schnabel, Renate B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between gender, process of care measures, and outcomes in ACS in India: results from the detection and management of coronary heart disease (DEMAT) registry</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-04-24</date><risdate>2013</risdate><volume>8</volume><issue>4</issue><spage>e62061</spage><epage>e62061</epage><pages>e62061-e62061</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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. 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&lt;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. 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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23637963</pmid><doi>10.1371/journal.pone.0062061</doi><oa>free_for_read</oa></addata></record>
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subjects Acute coronary syndrome
Acute Coronary Syndrome - diagnosis
Acute Coronary Syndrome - epidemiology
Acute Coronary Syndrome - therapy
Ambulatory Care
Anticoagulants
Aspirin
Cardiovascular disease
Cardiovascular diseases
Care and treatment
Chronic illnesses
Clopidogrel
Coronary artery disease
Diabetes
Disease control
Disease management
Dosage and administration
Female
Gandhi, Indira (1917-84)
Gender aspects
Gender differences
Health aspects
Heart
Heart diseases
Humans
India - epidemiology
Inpatients
Male
Management
Medicine
Men
Mortality
Outcome Assessment, Health Care
Patient outcomes
Prevention
Registries
Sex differences
Sex Factors
Socioeconomic Factors
Statins
title Association between gender, process of care measures, and outcomes in ACS in India: results from the detection and management of coronary heart disease (DEMAT) registry
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