More men than women get best care for heart attack

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An initiative by the American College of Cardiology has increased the number of heart attack patients who get guidelines-based care, but women are still less likely to benefit than men, researchers report.

The Guidelines Applied in Practice (GAP) program aimed to raise the quality of care for men and women who survived a heart attack. A major component of the effort was a “discharge document” that outlined best treatment options.

“The GAP program and its associated discharge document were important in increasing the rates of evidence-based care,” senior investigator Dr. Kim A. Eagle told Reuters Health.

Eagle, of the University of Michigan, Ann Arbor and colleagues investigated the management of about 1400 men and a like number of women who had been treated for a heart attack before or after the adoption of GAP.

The study, in the Archives of Internal Medicine, shows that “the GAP discharge tool was independently associated with a substantial reduction in mortality after discharge at 1 year in women.” Nevertheless, women were still significantly more likely to die than men.

The investigators found that 27.9% of women received a discharge document compared with 33.96% of men, a statistically significant difference. “Greater use of the GAP discharge tool in women might narrow the post-(heart attack) gender mortality gap,” the team concludes

Dr. Philip Greenland of Northwestern University, Chicago, co-author of an accompanying editorial, told Reuters Health, “The reasons for this persistent treatment inequality in women when there were standardized orders in place are not clear and require further examination.”

SOURCE: Archives of Internal Medicine, June 12, 2006.

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