Sex differences in adherence to treatment in patients with myocardial infarction

Abstract

The aim of the study is to identify factors affecting adherence to treatment in men and women with myocardial infarction (MI).Material and methods. The study included 150 patients diagnosed with MI (47 women and 103 men). Treatment readiness was assessed according to the S.V. Davydov method and with the calculation of the integral indicator of adherence to treatment (IIAT).Results. During 6-month follow-up, men and women with MI were comparable in mortality rates, however, men were more frequently hospitalized for cardiovascular complications. Adherence to treatment was high in both genders. Treatment readiness at the time of MI indicated higher satisfaction with the results of treatment in women, and higher willingness to pay for treatment, higher confidence in the treatment strategy and a higher IIAT in men. Both women and men with MI reported a comparable number of outpatient visits within 6 months (not exceeding 56 %). Only small number of patients reached the target heart rate (HR) and low-density lipoprotein (LDL) content within 6 months. Patients of both genders who reached and not reached the target LDL level and HR did not differ in mortality rates, hospitalizations and adherence to treatment within 6 months. At the same time, patients who reached the target HR, regardless of gender, were more likely to make outpatient postMI visits compared with those who did not reach the targets; men with MI who did not achieve the target HR were less likely to visit a doctor, whereas women with MI who achieved the target HR and LDL were more likely to have a high IIAT during in-patient care and were more willing to pay for further treatment (an exclusive characteristic of women who reached target HR). Moreover, we have identified predictors of IIAT and achievement of HR and LDL in women and men with MI.Conclusions. Patients with MI present with sex-specific factors that are affecting treatment adherence, which should be accounted for in the development of measures for secondary prevention of disease.