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dc.contributor.authorJohnston, Nina
dc.contributor.authorBornefalk-Hermansson, Anna
dc.contributor.authorSchenck-Gustafsson, Karin
dc.contributor.authorHeld, Claes
dc.contributor.authorGoodman, Shaun G.
dc.contributor.authorYan, Andrew T.
dc.contributor.authorBierman, Arlene S.
dc.date2022-08-11T08:08:08.000
dc.date.accessioned2022-08-23T15:43:50Z
dc.date.available2022-08-23T15:43:50Z
dc.date.issued2013-07-17
dc.date.submitted2013-10-17
dc.identifier.citation<p>Johnston N, Bornefalk-Hermansson A, Schenck-Gustafsson K, Held C, Goodman SG, Yan AT, Bierman AS. Do clinical factors explain persistent sex disparities in the use of acute reperfusion therapy in STEMI in Sweden and Canada? European Heart Journal: Acute Cardiovascular Care 2013;doi: 10.1177/2048872613496940</p>
dc.identifier.doi10.1177/2048872613496940
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27185
dc.description.abstractAims: This study examined clinical factors associated with sex differences in the use of acute reperfusion therapy (fibrinolysis or primary percutaneous coronary intervention) in ST-elevation myocardial infarction (STEMI) patients, and the interaction between sex and these factors in Sweden and Canada. Methods: Patients with STEMI in Sweden (n=32,676 from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions) were compared with similar patients in Canada (n=3375 from the Canadian Global Registry of Acute Coronary Events) for the period 2004–2008. Results: Unadjusted vs. age-adjusted odds ratios (OR) for no reperfusion (women vs. men) were for Sweden 1.57 (95% CI 1.49–1.64) vs. 1.14 (95% CI 1.08–1.20), and for Canada 1.61 (95% CI 1.39–1.87) vs. OR 1.18 (95% CI 1.01–1.39). Sex differences persisted after multivariable adjustments (including prehospital delay, atypical symptoms, diabetes), factors for which no interaction with sex was found. Among women <60 >years, adjusting for atypical symptoms in Canada and angiographic data in Sweden made the greatest contribution to explaining observed sex differences. Conclusions: In both countries, acute reperfusion therapy in STEMI was used less often in women than in men. Factors associated with these sex differences appear to differ between older and younger women. Targeted interventions are needed to optimize care for women with STEMI, as well as sex- and age-stratified reporting of quality indicators to assess their effectiveness.
dc.language.isoen_US
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821828/
dc.subjectMyocardial infarction
dc.subjectReperfusion therapy
dc.subjectSex differences
dc.subjectCardiology
dc.subjectCardiovascular Diseases
dc.subjectGender and Sexuality
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectTherapeutics
dc.subjectWomen's Health
dc.titleDo clinical factors explain persistent sex disparities in the use of acute reperfusion therapy in STEMI in Sweden and Canada?
dc.typeJournal Article
dc.source.journaltitleEuropean Heart Journal: Acute Cardiovascular Care
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_grace/114
dc.identifier.contextkey4732207
html.description.abstract<p><p id="x-x-x-p-1">Aims: This study examined clinical factors associated with sex differences in the use of acute reperfusion therapy (fibrinolysis or primary percutaneous coronary intervention) in ST-elevation myocardial infarction (STEMI) patients, and the interaction between sex and these factors in Sweden and Canada. <p id="x-x-x-p-2">Methods: Patients with STEMI in Sweden (<em>n</em>=32,676 from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions) were compared with similar patients in Canada (<em>n</em>=3375 from the Canadian Global Registry of Acute Coronary Events) for the period 2004–2008. <p id="x-x-x-p-3">Results: Unadjusted vs. age-adjusted odds ratios (OR) for no reperfusion (women vs. men) were for Sweden 1.57 (95% CI 1.49–1.64) vs. 1.14 (95% CI 1.08–1.20), and for Canada 1.61 (95% CI 1.39–1.87) vs. OR 1.18 (95% CI 1.01–1.39). Sex differences persisted after multivariable adjustments (including prehospital delay, atypical symptoms, diabetes), factors for which no interaction with sex was found. Among women <60 >years, adjusting for atypical symptoms in Canada and angiographic data in Sweden made the greatest contribution to explaining observed sex differences. <p id="x-x-x-p-4">Conclusions: In both countries, acute reperfusion therapy in STEMI was used less often in women than in men. Factors associated with these sex differences appear to differ between older and younger women. Targeted interventions are needed to optimize care for women with STEMI, as well as sex- and age-stratified reporting of quality indicators to assess their effectiveness.</p>
dc.identifier.submissionpathcor_grace/114
dc.contributor.departmentCenter for Outcomes Research


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