Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34234
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dc.contributor.authorDagan, Misha-
dc.contributor.authorDinh, Diem T-
dc.contributor.authorStehli, Julia-
dc.contributor.authorNan Tie, Emilia-
dc.contributor.authorBrennan, Angela-
dc.contributor.authorAjani, Andrew E-
dc.contributor.authorClark, David J-
dc.contributor.authorFreeman, Melanie-
dc.contributor.authorReid, Christopher M-
dc.contributor.authorHiew, Chin-
dc.contributor.authorOqueli, Ernesto-
dc.contributor.authorKaye, David M-
dc.contributor.authorDuffy, Stephen J-
dc.date2023-
dc.date.accessioned2023-11-15T05:28:10Z-
dc.date.available2023-11-15T05:28:10Z-
dc.date.issued2023-12-
dc.identifier.citationHeart, Lung & Circulation 2023-12; 32(12)en_US
dc.identifier.issn1444-2892-
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/34234-
dc.description.abstractLeft ventricular (LV) dysfunction and ischaemic heart disease (IHD) are common among women. However, women tend to present later and are less likely to receive guideline-directed medical therapy (GDMT) compared with men. We analysed prospectively collected data (2005-2018) from a multicentre registry on GDMT 30 days after percutaneous coronary intervention in 13,015 patients with LV ejection fraction <50%. Guideline-directed medical therapy was defined as beta blocker, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker±mineralocorticoid receptor antagonist. Long-term mortality was determined by linkage with the Australian National Death Index. Women represented 20% (2,634) of the total cohort. Mean age was 65±12 years. Women were on average >5 years, with higher body mass index and higher rates of hypertension, diabetes, renal dysfunction, prior stroke, and rheumatoid arthritis. Guideline-directed medical therapy was similar between sexes (73% vs 72%; p=0.58), although women were less likely to be on an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (80% vs 82%; p=0.02). Women were less likely to be on statin therapy (p<0.001) or a second antiplatelet agent (p=0.007). Women had higher unadjusted long-term mortality (25% vs 19%; p<0.001); however, there were no differences in long-term mortality between sexes on adjusted analysis (hazard ratio 0.99; 95% confidence interval 0.87-1.14; p=0.94). Rates of GDMT for LV dysfunction were high and similar between sexes; however, women were less likely to be on appropriate IHD secondary prevention. The increased unadjusted long-term mortality in women was attenuated in adjusted analysis, which highlights the need for optimisation of baseline risk to improve long-term outcomes of women with IHD and comorbid LV dysfunction.en_US
dc.language.isoeng-
dc.subjectOptimal medical therapyen_US
dc.subjectPharmacotherapyen_US
dc.subjectSecondary preventionen_US
dc.subjectSex differencesen_US
dc.subjectWomen's heart diseaseen_US
dc.titleSex Differences in Pharmacotherapy and Long-Term Outcomes in Patients With Ischaemic Heart Disease and Comorbid Left Ventricular Dysfunction.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleHeart, Lung & Circulationen_US
dc.identifier.affiliationDepartment of Cardiology, Alfred Hospital, Melbourne, Vic, Australia.en_US
dc.identifier.affiliationCentre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia.en_US
dc.identifier.affiliationDepartment of Cardiology, Alfred Hospital, Melbourne, Vic, Australia.en_US
dc.identifier.affiliationCentre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Vic, Australia.en_US
dc.identifier.affiliationDepartment of Cardiology, Box Hill Hospital, Melbourne, Vic, Australia.en_US
dc.identifier.affiliationCentre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia; School of Population Health, Curtin University, Perth, WA, Australia.en_US
dc.identifier.affiliationDepartment of Cardiology, University Hospital Geelong, Geelong, Vic, Australia; School of Medicine, Deakin University, Melbourne, Vic, Australia.en_US
dc.identifier.affiliationDepartment of Cardiology, Ballarat Base Hospital, Melbourne, Vic, Australia.en_US
dc.identifier.affiliationDepartment of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University, Melbourne, Vic, Australia.en_US
dc.identifier.affiliationCentre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia; Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University, Melbourne, Vic, Australia.en_US
dc.identifier.affiliationCardiologyen_US
dc.identifier.doi10.1016/j.hlc.2023.09.008en_US
dc.type.contentTexten_US
dc.identifier.pubmedid37945426-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.languageiso639-1en-
item.cerifentitytypePublications-
item.grantfulltextnone-
crisitem.author.deptCardiology-
crisitem.author.deptUniversity of Melbourne Clinical School-
Appears in Collections:Journal articles
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