Gender Disparities in Patients’ Decisions about the Management of Myocardial Infarction in East Chinese Province

Abstract

Background. Previous studies showed that there are gender disparities in various respects of acute myocardial infarction (AMI), including risk factors, symptoms, and outcomes. However, few of them noticed the gender disparities in patients’ decision about the management of AMI, which might also be associated with the outcome. Aims. To identify gender disparities in patients’ decisions about the management of myocardial infarction. Methods. In this cohort study, the critical time points including the time of symptom onset, visiting hospital, diagnosis of AMI, consent to coronary angiography (CAG), beginning of CAG, and balloon dilation were recorded. Medication and major adverse cardiac event (MACE) within 6 months were also recorded. Results. Female patients took more time from symptom onset to visiting hospital ( $P=0.001$ ), from diagnosis of AMI to consent to CAG ( $P<0.05$ ), and from door to needle/balloon than male ( $P<0.05$ ). Less female patients accepted CAG ( $P<0.05$ ) and coronary intervention/bypass grafting ( $P<0.05$ ). Less female patients kept good inherence to antiplatelet therapy ( $P<0.05$ ) and statins ( $P<0.05$ ) than male, more female preferred traditional Chinese medicine (TCM) than male patient ( $P<0.05$ ), and most of them had MACE within 6 months ( $P<0.05$ ). Patients’ good adherence to antiplatelet therapy and statins and accepting coronary intervention/bypass grafting were associated with a reduced risk of MACE. Conclusion. Female patients were more reluctant to make decisions about emergency management of AMI and tended to choose conservative treatment. More female patients preferred TCM than evidence-based medicine. Their reluctance about the critical management of AMI and poor adherence to evidence-based medicine were associated with an elevated risk of MACE.