[The therapeutic effort on admission for women with an acute myocardial infarct. The Valencia Group for the Study of Hospital Inequities in Health]. / Esfuerzo terapéutico al ingreso en mujeres con infarto agudo de miocardio. Grupo Valenciano para el Estudio de las Desigualdades Hospitalarias en Salud.

ABSTRACT

BACKGROUND: Recent studies have suggested that women with ischemic heart disease receive lesser therapeutic care than males. The aim of this study was to verify the hypothesis that sex is an independent predictive factor in therapeutic care upon admission in patients with acute myocardial infarction. METHODS: Secondary analysis was performed by multiple linear regression of 429 males and 124 females admitted to 6 general intensive care units for acute myocardial infarction. Therapeutic effort was measured according to the Therapeutic Intervention Scoring System (TISS) index. Age, initial severity measured by the Simplified Acute Physiological Score (SAPS) and the Killip group were considered as possible variables of confusion upon admission. RESULTS: Upon comparison with males the group of women was characterized by a greater age (p < 0.0001), higher SAPS score (p = 0.0028) and lesser relative therapeutic effort (p = 0.0990), and a higher Killip group upon admission (p < 0.0001). Regression analysis identified the Killip group (p < 0.0001), the SAPS index (p < 0.0001) and age (p = 0.0011) but not sex (p = 0.3875) as independent predictors of therapeutic effort. CONCLUSIONS: The results of the present study do not support the hypothesis that sex is an independent predictor of therapeutic effort. The indexes of lesser relative therapeutic effort in women admitted for acute myocardial infarction were found to be attributed to a higher mean age.