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Healthcare disparities for women hospitalised with myocardial infarction and angina
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dc.contributor.author | Jackson, Alice M. | |
dc.contributor.author | Zhang, Ruiqi | |
dc.contributor.author | Robertson, Keith | |
dc.contributor.author | Lindsay, Mitchell | |
dc.contributor.author | Morris, Tamsin | |
dc.contributor.author | Forbes, Brian | |
dc.contributor.author | Papworth, Richard | |
dc.contributor.author | McConnachie, Alex | |
dc.contributor.author | Mangion, Kenneth | |
dc.contributor.author | Jhund, Pardeep S. | |
dc.contributor.author | McCowan, Colin | |
dc.contributor.author | Berry, Colin | |
dc.date.accessioned | 2020-07-24T23:36:00Z | |
dc.date.available | 2020-07-24T23:36:00Z | |
dc.date.issued | 2019-07-25 | |
dc.identifier | 260440235 | |
dc.identifier | 0575f29a-9d8c-41b6-9dbc-9427f071615f | |
dc.identifier | 85083041749 | |
dc.identifier | 000553310700011 | |
dc.identifier.citation | Jackson , A M , Zhang , R , Robertson , K , Lindsay , M , Morris , T , Forbes , B , Papworth , R , McConnachie , A , Mangion , K , Jhund , P S , McCowan , C & Berry , C 2019 , ' Healthcare disparities for women hospitalised with myocardial infarction and angina ' , European Heart Journal - Quality of Care and Clinical Outcomes . https://doi.org/10.1093/ehjqcco/qcz040 | en |
dc.identifier.issn | 2058-5225 | |
dc.identifier.other | ORCID: /0000-0002-9466-833X/work/60427734 | |
dc.identifier.uri | https://hdl.handle.net/10023/20334 | |
dc.description.abstract | Ischaemic heart disease persists as the leading global cause of death. Myocardial infarction (MI) accounts for a large proportion of death due to cardiovascular disease. Between 2007 and 2016, age-sex standardised mortality for MI in Scotland has fallen by 42.5% from 129 to 74 per 100,000 population – a trend also apparent in other countries. Despite improvements in survival, considerable disparities exist according to sexin terms of delivery of guideline-recommended treatments and outcomes following MI suggesting women may be disadvantaged. Use of high-sensitivity troponin assays with sex-specific thresholds increases the detection of MI in women. However, women are less likely to undergo percutaneous coronary revascularisation (PCI) and are more often subject to underutilisation of evidence-based secondary preventative pharmacotherapy. Differences in adoption of invasive management may, in part, be explained by a perception held by clinicians and patients that outcomes are worse for women receiving PCI, as well as differences in symptoms and baseline risk profile which may impact clinical decision-making. Adverse events post-MI, including cardiogenic shock, heart failure and death, remain more common in women than in men, most notably in those with ST-elevation myocardial infarction (STEMI). Whether sex remains an independent predictor of adverse events despite adjustments for the higher risk-profile of women, notably age, is less clear. We hypothesised that sex-related differences in demographics and comorbidity underpin disparities in management and outcomes of women and men hospitalised with MI or angina. We investigated this hypothesis by analysis of a contemporary secondary care electronic registry (e-Registry) using electronic patient records (EPRs) for patients admitted to a complex regional healthcare network. | |
dc.format.extent | 262695 | |
dc.language.iso | eng | |
dc.relation.ispartof | European Heart Journal - Quality of Care and Clinical Outcomes | en |
dc.subject | RA0421 Public health. Hygiene. Preventive Medicine | en |
dc.subject | RC Internal medicine | en |
dc.subject | NDAS | en |
dc.subject | SDG 3 - Good Health and Well-being | en |
dc.subject.lcc | RA0421 | en |
dc.subject.lcc | RC | en |
dc.title | Healthcare disparities for women hospitalised with myocardial infarction and angina | en |
dc.type | Journal article | en |
dc.contributor.institution | University of St Andrews. School of Medicine | en |
dc.contributor.institution | University of St Andrews. Sir James Mackenzie Institute for Early Diagnosis | en |
dc.identifier.doi | 10.1093/ehjqcco/qcz040 | |
dc.description.status | Peer reviewed | en |
dc.date.embargoedUntil | 2020-07-25 |
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