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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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 |
doi_str_mv | 10.1371/journal.pone.0062061 |
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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<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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0062061</identifier><identifier>PMID: 23637963</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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</subject><ispartof>PloS one, 2013-04, Vol.8 (4), p.e62061-e62061</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Pagidipati et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Pagidipati et al 2013 Pagidipati et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-5591d8b9f0bbdbf53d4e5f02dbd1a5445f633680553c3963f1b7e26b1c949b973</citedby><cites>FETCH-LOGICAL-c593t-5591d8b9f0bbdbf53d4e5f02dbd1a5445f633680553c3963f1b7e26b1c949b973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634747/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634747/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23637963$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Schnabel, Renate B.</contributor><creatorcontrib>Pagidipati, Neha J</creatorcontrib><creatorcontrib>Huffman, Mark D</creatorcontrib><creatorcontrib>Jeemon, Panniyammakal</creatorcontrib><creatorcontrib>Gupta, Rajeev</creatorcontrib><creatorcontrib>Negi, Prakash</creatorcontrib><creatorcontrib>Jaison, Thannikot M</creatorcontrib><creatorcontrib>Sharma, Satyavan</creatorcontrib><creatorcontrib>Sinha, Nakul</creatorcontrib><creatorcontrib>Mohanan, Padinhare</creatorcontrib><creatorcontrib>Muralidhara, B G</creatorcontrib><creatorcontrib>Bijulal, Sasidharan</creatorcontrib><creatorcontrib>Sivasankaran, Sivasubramonian</creatorcontrib><creatorcontrib>Puri, Vijay K</creatorcontrib><creatorcontrib>Jose, Jacob</creatorcontrib><creatorcontrib>Reddy, K Srinath</creatorcontrib><creatorcontrib>Prabhakaran, Dorairaj</creatorcontrib><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</title><title>PloS one</title><addtitle>PLoS One</addtitle><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<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.</description><subject>Acute coronary syndrome</subject><subject>Acute Coronary Syndrome - diagnosis</subject><subject>Acute Coronary Syndrome - epidemiology</subject><subject>Acute Coronary Syndrome - therapy</subject><subject>Ambulatory Care</subject><subject>Anticoagulants</subject><subject>Aspirin</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>Chronic illnesses</subject><subject>Clopidogrel</subject><subject>Coronary artery disease</subject><subject>Diabetes</subject><subject>Disease control</subject><subject>Disease management</subject><subject>Dosage and administration</subject><subject>Female</subject><subject>Gandhi, Indira (1917-84)</subject><subject>Gender aspects</subject><subject>Gender differences</subject><subject>Health aspects</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Inpatients</subject><subject>Male</subject><subject>Management</subject><subject>Medicine</subject><subject>Men</subject><subject>Mortality</subject><subject>Outcome Assessment, Health Care</subject><subject>Patient outcomes</subject><subject>Prevention</subject><subject>Registries</subject><subject>Sex differences</subject><subject>Sex Factors</subject><subject>Socioeconomic 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between gender, process of care measures, and outcomes in ACS in India: results from the detection and management of coronary heart disease (DEMAT) registry</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c593t-5591d8b9f0bbdbf53d4e5f02dbd1a5445f633680553c3963f1b7e26b1c949b973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Acute coronary syndrome</topic><topic>Acute Coronary Syndrome - diagnosis</topic><topic>Acute Coronary Syndrome - epidemiology</topic><topic>Acute Coronary Syndrome - therapy</topic><topic>Ambulatory 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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<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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language | eng |
recordid | cdi_plos_journals_1346154599 |
source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
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 |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T02%3A43%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Association%20between%20gender,%20process%20of%20care%20measures,%20and%20outcomes%20in%20ACS%20in%20India:%20results%20from%20the%20detection%20and%20management%20of%20coronary%20heart%20disease%20(DEMAT)%20registry&rft.jtitle=PloS%20one&rft.au=Pagidipati,%20Neha%20J&rft.date=2013-04-24&rft.volume=8&rft.issue=4&rft.spage=e62061&rft.epage=e62061&rft.pages=e62061-e62061&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0062061&rft_dat=%3Cgale_plos_%3EA478023331%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1346154599&rft_id=info:pmid/23637963&rft_galeid=A478023331&rft_doaj_id=oai_doaj_org_article_167e06370ca9432283ade390e9164a04&rfr_iscdi=true |