Pharmacological approach to patients with non-ST segment elevation myocardial infarction: does sex make a difference?

INTRODUCTION A number of the recently published papers have suggested that high mortality among women with acute coronary syndromes might be related to suboptimal pharmacological treatment, namely to the lower rate of administration of antiplatelet agents, statins, β-blockers, and angiotensin-converting enzyme inhibitors (ACEIs). OBJECTIVES The aim of the study was to compare pharmacotherapy between women and men with non-ST-segment elevation myocardial infarction (NSTEMI) treated in cardiology and general internal medicine wards. PATIENTS AND METHODS A total of 682 consecutive patients (43.4% of women) with NSTEMI were hospitalized in a reference cardiology ward and several internal medicine wards between June 1, 2005 and May 31, 2006 in the Świętokrzyskie region of Poland (over 1 million inhabitants). Data were obtained from the Polish Acute Coronary Syndrome Registry. In-hospital and discharge pharmacotherapy in men and women were compared. RESULTS Ticlopidine, clopidogrel, and unfractionated heparin were administered in the cardiology ward significantly more frequently than elsewhere. Acetylsalicylic acid was used with similar frequency in all wards. There were no significant differences in pharmacotherapy between male and female patients admitted to cardiology and other wards. Acetylsalicylic acid, clopidogrel, ACEIs, statins, and β-blockers were prescribed significantly less frequently at discharge from internal medicine wards than from the cardiology ward. The proportion of patients receiving specific drugs was similar among women and men. CONCLUSIONS We did not observe significant differences in pharmacotherapy between women and men within a particular facility. Patients discharged from internal medicine wards were prescribed β-blockers, statins, and ACEI significantly less frequently.