Does the gender gap still persist after myocardial infarction? Treatments and outcomes in VALIANT

Velazquez, E.J., Moreira, M., Rouleau, J.L., Swedberg, K., Kvasnicka, J., Marin-Neto, J.A., Manes, C., Pfeffer, M.A. and McMurray, J. (2004) Does the gender gap still persist after myocardial infarction? Treatments and outcomes in VALIANT. Journal of Cardiac Failure, 10(4), S114. (doi: 10.1016/j.cardfail.2004.06.357)

Abstract

Purpose: Previously women were shown to receive inferior treatment and have worse outcomes than men after acute myocardial infarction (MI). We examined whether this “gender gap” persists in the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. Methods: VALIANT enrolled 14,703 patients (31% women) with left ventricular systolic dysfunction (LVSD), heart failure (HF), or both 12 hours to 10 days post-MI (median 4.9 days). The independent effect of gender on all-cause death, cardiovascular (CV) death, or hospitalization for HF and a broader composite CV endpoint (CV death, MI, hospitalization for HF, stroke, or resuscitated sudden death) over the 3 years after randomization was examined using multivariable (MV) modelling. Results: Women were older than men (69.3 yrs vs 62.8 yrs; P<0.0001), had more co-morbidity, and less often received standard drug therapy or coronary procedures (Table). Three-year mortality rates were: women 23.2%, men 17.8%. Substantially more women developed HF. CV death or HF hospitalization was: women 34%, men 24%; in the MV model, gender was an independent predictor of this outcome (HR 1.13; 95% CI 1.04–1.22) but not of overall death. Composite CV endpoint rates were: women 38.7%, men 30.1% (HR 1.12; 1.04–1.20). Conclusions: Significant differences in the treatment of men and women persist after MI. The risk for HF remains higher in women and the effect of gender on CV morbidity requires further investigation.

• Item Type: Articles
• Additional Information: Abstracts from the 8th Annual Scientific Meeting of the Heart Failure Society of America.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McMurray, Professor John
• Authors: Velazquez, E.J., Moreira, M., Rouleau, J.L., Swedberg, K., Kvasnicka, J., Marin-Neto, J.A., Manes, C., Pfeffer, M.A., and McMurray, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Journal of Cardiac Failure
• Publisher: Elsevier
• ISSN: 1071-9164
• ISSN (Online): 1532-8414