Prognostic impact of high-intensity lipid-lowering therapy under-prescription after acute myocardial infarction in women
Author:
Weizman Orianne12ORCID, Hauguel-Moreau Marie2, Tea Victoria1, Albert Franck3, Barragan Paul4, Georges Jean-Louis5ORCID, Delarche Nicolas6, Kerneis Mathieu7ORCID, Bataille Vincent8, Drouet Elodie910, Puymirat Etienne1ORCID, Ferrières Jean11, Schiele François12, Simon Tabassome8, Danchin Nicolas113, , Albert F, Aliot E, Allal J, Allam S, Allard-Latour G, Amat G, Amor M, Andriambololona M, Assayag P, Asseman P, Banos J-L, Baradat G, Bardet J, Bareiss P, Barnay C, Bassand J-P, Baudouy M, Baudouy P, Baulleret G, Bazin P, Beaufils P, Beauverger Y-M, Becquart J, Belle L, Berland J, Bernard P, Beruben E, Bessede G, Bickert P, Bineau-Jorisse A, Blanc J-J, Blanchard D, Bonneau A, Bonnet P, Bourdon J-L, Boureux C, Boutaud P, Bouvier J-M, Brunel H-P, Cazenave P, Cador R, Cardinaud P, Carette B, Carlioz , Casteigt F, Cattan S, Cazaux P, Chaussard C, Charbonnier B, Chounet J, Claudon O, Coatantiec G, Coeurderoy A, Convert G, Coste P, Coulon P, Coupillaud J, Courdier G, Cressens J-P, Cribier A, D'Amato J, Dambrine P, Danchin N, De Boisgelin X, Delarche N, Dentan G, Destrac S, Deturck R, Dewilde J, Dibie A, Djiane P, Doazan J-P, Druelles P, Dubourg O, Duclos F, Dujardin J-J, Dulhoste M-N, Dupouy P, Elaerts J, Elgohary , Elhadad S, Escande-Orthlieb M, Escojido H, Estampes B, Eymerit P, Fichter P, Flammang D, Font M, Fourdilis M, Fournier P, Francoual M, Fromage P, Galley D, Garnier H, Gauffre O, Genet L, Geslin P, Ghanem M, Godard S, Godenir J-P, Goburdhun C, Grison D, Grollier G, Gueniche C, Guenot O, Gueret P, Guerin Y, Guillot J-P, Gully C, Halary J-J, Hannebicque G, Mycinski C, Hanssen M, Heiligenstein D, Heraudeau A, Hochart P, Hueber A, Huguet R-G, Huret B, Jambert H, Jebai , Jullien J, Karsenty B, Khalife K, Kahn J-C, Kirkorian G, Lagorce P, Lahneche , Lancelin B, Lang M, Lanteme P, Lapeyre G, Lardoux H, Lassabe A, Laurent Y, Leclercq F, Ledain L, Lefevre T, Lemoine C, Levai L, Le Marrec , Mabo P, Machecourt J, Magnin D, Mailler J-P, Marier J-J, Marco F, Marcon J-L, Martelet M, Meimoun P, Messner-Pellenc P, Mettauer B, Metzger J-P, Meurice T, Monassier J-P, Monnier A, Monsegu J, Montely J-M, Morice J, Mossard J-M, Normand , Olive , Oltean I, Paemelaere J-M, Paganelli F, Pagny J-Y, Pailloncy M, Palcoux M-C, Parola J-L, Peltier B, Pernes J-M, Pichene M, Pierre-Justin E, Pochmalicki G, Poitrineau O, Ponsonnaille J, Poulard J-E, Pruvost P, Puel J, Quandalle P, Quiret J-C, Rebuffat G, Rihani R, Ritz B, Rioux P, Rouffaud J, Rondepierre D, Ronteix J-F, Saadouni E-H, Sader R, Sans P, Sarfati L, Sivery B, Slama M, Soto F-X, Tabone X, Thieuleux F, Thisse J-Y, Thourot G, Tissot M, Tissot T-A, Toussaint C, Traisnel G, Tran , Tremeau G, Vahanian A, Michel P-L, Valeix B, Vahdat B, Vergnouix H, Viallet M, Vilarem D, Virot P, Vittrant J, Weber S, Wolf J-E, Wyart P, Zabel A, Zupan Sihcus M, Cottin Y, Coste P, Lognogne T, Roul G, De Breyne B, Moulin F, Khalife K, Vanzetto G, Carrie D, Jouve B, Leurent G, Schiele F, Hammer L, Faure E, Probst V, Boschat J, Motreff P, Ritz B, Le RAY C, Andrieu S, Lucke V, Rouault G, Faure J P, Levy G, Leclercq F, Robin C, Valy Y, Asseman P, Danchin N, Schmutz L, Delarche N, Wiedemann J Y, Tabone X, Pacouret G, Schwob J, Lim P, Orion L, El Moujahid M, Druelles P, Belle L, Fajadet J, Perron J M, Henry P, Rosak P, Ducrocq G, Tron C, Duvilla N, Elhadad S, Demicheli T, Rouselle V, Cazaux S, Ballout J, Genet L, Herce B, Banos J L, Jarry G, Benamer H, Montely J M, Joly P, Paganelli F, Delaunay R, Tibi T, Dentan G, Boulard P, Champagnac D, Soto F X, Bonnet J L, Le Francois Y, Duclos F, Luycx-Bore A, Boureux C, Collet J P, Dupouy P, Ravan R, Amor M, Bonnet P, Marchand X, Bourkaib R, Ben AMER H, Maillier B, Pilliere R, Bernard P, Coisne D, Berthier R, Fayard M, Magdelaine B, Pichene M, Werquin S, Aelion H, Boccara A, Armengaud J, Meyer P, Ferrari E, Jarnier P, Karsenty B, Bodart J C, Jullien T, Barragan P, Koujan B, Dadez E, Huret B, Boueri Z, Graux P, Lantelme P, Le BRIS H, Nait Saidi L, Raoux F, Coco M, Monassier J P, Favereau X, Brasselet C, Traisnel G, Dupouy P, Nallet O, Cerisier A, Chevalier B, Furber A, Koegler A, Sedighian S, Petiteau P Y, Perrot S, Bessede G, Verdun A, Fourrier J L, Maillard L, Brunel P, Coupillaud J, Slama M, Sader R, Darchis J, Elkaim J P, Vahdat B, Kamal H, Zaehringer M, Philippe F, Cador R, Bettioui A, Poulard J E, Allard Latour G, Broucqsault D, Ettori J, Bernasconi F, Casteigt F, Hueber A, Mettauer B, Schiano P, Loiselet P, Roynard J L, Martelet M, Godenir J P, Dujardin J J, Saadouni H, Fromage P, Michel L, Ley N, Breut C, Faverau X, Fonseca E, Allam S, Beruben E, Admant P, Cohen A, Laurent I, Haas J, Eymerit P, Lescure M, Gabriel A, Belhassane A, Litalien J, Souk-Aloun J, Fourrier J L, Rioux P, Brunelle F, Hamani D, Sarfati L, Thieuleux F, Berenfeld A, Airaud P, Decoulx E, Heroguelle V, Claudel J P, Ribier A, Cellarier G, Magnin D, Megbemado R, Mischke U, Baborier D, Thisse J Y, Jellouli B, Demarcq J M, Hugon J P, Funck F, Mteirek M, Bourdon J L, Dutoit L, Bineau-Jorisse A, Joly P, Ray J P, Tarragano F, Jebai H, Baradat G, Tissot M, Bureau G, Decourcelle V, Halary J J, Bienvenu M P, D'Hautefeuille B, Gosselin G, Coz E, Claudon O, Galley D, Benderbous R, Destrac S, Jouve B, Peycher P, Rumeau P, Leborgne L, Furber A, Lucke Simandoux V, Bernasconi F, Duclos F, Saint-Pierre F, Grebet J, Haddad V, Jessen P, Walylo F, Dutoit L, Soto F, Andrieu S, Sainsous J, Faure A, Labeque J, Dumessi K, Lefrancois Y, Baciulescu L, Petiteau P, Schiele F, Mycinski C, Kadri A, Marque N, Gommeaux A, Darremont O, Laine M, Mansencal N, Nugue O, Mayaud N, Tabone X, Castellant P, Faure J, De Breyne B, Beygui F, Richard P, Tremeau G, Tibi T, Grossetete R, Salva P, Beruben E, Fayard M, Descotes-Genon V, Angoulvant D, Houeze F, Poitrineau O, Pon-Gabrielsen P, Slama M, Motreff P, Greciano S, Plastaras P, Luycx Bore A, Berthier R, Baixas C, Aouate P, Lim P, Roynard J, Farhat A, Cottin Y, Napporn G, Jabourek O, Werquin S, Baala B, Admant P, Breton C, Taamallah S, Dentan G, Lamit X, Hidoud A, Poulos N, Marchand S, De Poli F, Diallo A, Orion L, Valy Y, Vanzetto G, Beaudet B, Deslandes Y, Charbonnel C, Demichelli T, Lesault P, Assayag P, Rosak P, Gostine S, De Tauriac O, El Moujahid M, Chevalevreau P, Lemesle G, Meurice T, Bontemps T, Aboyans V, Landel J, Durup F, Cazaux P, Perret T, Harbaoui B, Bert-Marcaz P, Bouvier J, Paganelli F, Bonnet J L, Khanoyan P, Bouriche F, Lefevre T, Jellouli B, Gasmi M, Khalife K, Moulin F, Rougier P, Somody E, De Labriole A, Milon C, Nallet O, Bonnet P, Roche R, Levy G, Leclercq F, Boccara A, Cornec P, Bresson D, Schultz R, Pichene M, Digne F, Probst V, Dib J C, Ballout J, Ferrari E, Maupas E, Cayla G, Lucas G, Genee O, Dibon O, Saal J, Henry P, Cohen A, Silvain J, Cador R, Varenne O, Danchin N, Ducrocq G, Delarche N, Jarnier P, Sultan P, Karsenty B, Coste P, Marchand X, Coisne D, Funck F, Belle L, Joseph T, Chayeb S, Brasselet C, Herve B, Druelles P, Mabo P, Flork L, Kaaki A, Souk Aloun J, Legros G, Du Villa N, Tron C, Taldir G, Guyon P, Isaaz K, Haddad Z, Jebai H, Mihoubi A, Brignon M, Temam R, Saouli D, Godreuil C, Chmait A, Remy J, Tchtchoua D, Henon P, Deltreuil M, Grentzinger A, Richard C, Pacaud D, Ettori J, Ledon S, Zaehringer M, Ohlmann P, Scemama A, Beard T, Dupont J, Poyet R, Farah B, Elbaz M, Delcoux E, Muligo A, Maillier B, Berenfeld A, Champin S, Moussa K, Popovic B, Le Ray C, Onceanu S, Marcaggi X, Maes D, Salengro E
Affiliation:
1. Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou (HEGP) , 20 rue Leblanc, 75015 Paris , France 2. Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), CHU Ambroise Paré , 9 avenue Charles de Gaulle, 92100 Boulogne Billancourt , France 3. Department of Cardiology, Centre Hospitalier Louis Pasteur , 4 Allée Claude Bernard, 28630 Le Coudray , France 4. Department of Cardiology, Polyclinique Les Fleurs , 322 Avenue Frédéric Mistral, 83190 Ollioules , France 5. Department of Cardiology, Centre Hospitalier de Versailles, Hôpital André Mignot , 177 Rue de Versailles, 78150 Le Chesnay-Rocquencourt , France 6. Department of Cardiology, Centre Hospitalier de Pau , 4 Bd Hauterive, 64000 Pau , France 7. ACTION Study Group, Department of Cardiology, Hôpital Pitié-Salpêtrière (AP-HP), Sorbonne Université, Cardiology Institute , Boulevard de l‘Hôpital, 75013 Paris , France 8. Department of Cardiology B and Epidemiology, Toulouse University Hospital, UMR INSERM 1027 , 2 Rue Charles Viguerie, 31300 Toulouse , France 9. Department of Clinical Pharmacology, AP-HP, Hôpital Saint Antoine, and Unité de Recherche Clinique (URCEST) , 184 Rue du Faubourg Saint Antoine, 75012 Paris , France 10. Université Pierre et Marie Curie (UPMC-Paris 06), INSERM U-698 , 16 rue Henri-Huchard - B.P. 416, 75877 Paris Cedex 18 , France 11. Department of Cardiology, Centre Hospitalier Universitaire Rangueil , 2 Rue Charles Viguerie, 31300 Toulouse , France 12. Department of Cardiology, University Hospital Jean Minjoz , 3 Boulevard Alexandre Fleming, 25030 Besançon , France 13. Department of Cardiology, Hôpital Paris St Joseph , 285 rue Raymond Losserand, 75014 Paris , France
Abstract
Abstract
Aims
Women are less likely to receive lipid-lowering therapy (LLT) after acute myocardial infarction (AMI). We analysed whether this under-prescription currently persists and has an impact on long-term outcomes.
Methods and results
The FAST-MI programme consists of nationwide registries including all patients admitted for AMI ≤ 48 h from onset over a 1 month period in 2005, 2010, and 2015, with long-term follow-up. This analysis focused on high-intensity LLT (atorvastatin ≥ 40 mg or equivalent, or any combination of statin and ezetimibe) in women and men. Women accounted for 28% (N = 3547) of the 12 659 patients. At discharge, high-intensity LLT was significantly less prescribed in women [54 vs. 68% in men, P < 0.001, adjusted odds ratio (OR) 0.78(95% confidence interval (CI) 0.71–0.87)], a trend that did not improve over time: 2005, 25 vs. 35% (P = 0.14); 2010, 66 vs. 79% (P < 0.001); 2015, 67 vs. 79.5% (P = 0.001). In contrast, female sex was not associated with a lack of other recommended treatments at discharge: beta-blockers [adjusted OR 0.98(95% CI 0.88–1.10), P = 0.78], or renin–angiotensin blockers [adjusted OR 0.94(95% CI 0.85–1.03), P = 0.18]. High-intensity LLT at discharge was significantly associated with improved 5 year survival and infarct- and stroke-free survival in women [adjusted hazard ratios (HR) 0.74(95% CI 0.64–0.86), P < 0.001 and adjusted HR: 0.81(95% CI: 0.74–0.89); P < 0.001, respectively]. Similar results were found using a propensity score-matched analysis [HR for 5 year survival in women with high-intensity LLT: 0.82(95% CI 0.70–0.98), P = 0.03].
Conclusion
Women suffer from a bias regarding the prescription of high-intensity LLT after AMI, which did not attenuate between 2005 and 2015, with potential consequences on both survival and risk of cardiovascular events.
Funder
FAST-MI programme from Amgen AstraZeneca Bayer BMS Daiichi Sankyo Eli Lilly MSD Pfizer Sanofi Servier
Publisher
Oxford University Press (OUP)
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