Evidence map›Paper›PMID 39206727›Full record

ArticleJournal of the American Heart Association2024

Sex Disparities in the Management of Acute Coronary Syndromes: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program.

Michael Sola, Elise Mesenbring, Thomas J Glorioso, Sarah Gualano, Tamara Atkinson, Claire S Duvernoy, Stephen W Waldo

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Michael SolaDivision of Cardiology, Department of Medicine University of Colorado Aurora CO USA.ORCID 0000-0003-2576-6320
Elise MesenbringCART Program, Office of Quality and Patient Safety Veterans Health Administration Washington DC USA.
Thomas J GloriosoCART Program, Office of Quality and Patient Safety Veterans Health Administration Washington DC USA.ORCID 0000-0002-7152-3998
Sarah GualanoVA Ann Arbor Healthcare System Ann Arbor MI USA.
Tamara AtkinsonPortland VA Medical Center Portland OR USA.
Claire S DuvernoyVA Ann Arbor Healthcare System Ann Arbor MI USA.ORCID 0000-0002-2879-9876
Stephen W WaldoDivision of Cardiology, Department of Medicine University of Colorado Aurora CO USA.ORCID 0000-0003-0678-4873

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious work has demonstrated disparities in the management of cardiovascular disease among men and women. We sought to evaluate these disparities and their associations with clinical outcomes among patients admitted with acute coronary syndromes to the Veterans Affairs Healthcare System. METHODS AND

resultsWe identified all patients that were discharged with acute coronary syndromes within the Veterans Affairs Healthcare System from October 1, 2015 to September 30, 2022. Medical and procedural management of patients was subsequently assessed, stratified by sex. In doing so, we identified 76 454 unique admissions (2327 women, 3.04%), which after propensity matching created an analytic cohort composed of 6765 men (74.5%) and 2295 women (25.3%). Women admitted with acute coronary syndromes were younger with fewer cardiovascular comorbidities and a lower prevalence of preexisting prescriptions for cardiovascular medications. Women also had less coronary anatomic complexity compared with men (5 versus 8, standardized mean difference [SMD]=0.40), as calculated by the Veterans Affairs SYNTAX score. After discharge, women were significantly less likely to receive cardiology follow-up at 30 days (hazard ratio [HR], 0.858 [95% CI, 0.794-0.928]) or 1 year (HR, 0.891 [95% CI, 0.842-0.943]), or receive prescriptions for guideline-indicated cardiovascular medications. Despite this, 1-year mortality rates were lower for women compared with men (HR, 0.841 [95% CI, 0.747-0.948]).

conclusionsWomen are less likely to receive appropriate cardiovascular follow-up and medication prescriptions after hospitalization for acute coronary syndromes. Despite these differences, the clinical outcomes for women remain comparable. These data suggest an opportunity to improve the posthospitalization management of cardiovascular disease regardless of sex.

Indexed as

Acute Coronary SyndromeHealthcare DisparitiesUnited States Department of Veterans AffairsAgedFemaleHumansMaleMiddle AgedSex FactorsUnited Statesacute coronary syndromessex disparitiesveterans affairs

Identifiers

PMID39206727
PMCPMC11646537

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.