Pharmacological Treatment After Acute Coronary Syndrome: Baseline Clinical Characteristics and Sex Differences in a Population-Based Cohort Study.

Abstract

Background: Cardiovascular disease remains the most common cause of death worldwide. Some differences between sexes in secondary prevention pharmacological therapies after an acute coronary syndrome (ACS) have been described, being women less likely to be treated. The aim was to to describe baseline socio-demographic and clinical characteristics and drugs prescribed for secondary prevention after a first episode of ACS in a Primary Health Care cohort population in Catalonia (Spain) and to assess differences between sexes.Methods: Population-based observational cohort study of patients with a first episode of ACS during 2009-2016. Data source: Information System for Research in Primary Care (SIDIAP) database. Results: There were 8,071 patients included, 71.3% of them were men and 80.2% had an acute myocardial infarction (AMI). Their mean age was 65.3, being older the women than the men. The most frequent comorbidities were hypertension, dyslipidaemia and diabetes and they were more common in women. Antiplatelets (91.3%) and statins (85.7%) were the study drugs most prescribed. The uses of all comedications were significantly higher in women, except for nitrates. The combination of four study groups was initially prescribed in 47.7% of patients and combination of beta-blockers, statins and antiplatelets was prescribed in 18.4%. More men than women received all recommended pharmacological groups.Conclusion: Women were older, had more comorbidities and received more comedication. Most patients were treated with a combination of four or three study drugs for secondary prevention. Men initiated more treatments for secondary prevention and dual antiplatelet therapy than women.