Abstract 9445: Gender Disparities in Statin Prescriptions Following Acute Coronary Syndrome

Abstract

Introduction: Initiation of high intensity statin therapy for patients following acute coronary syndrome (ACS) is well-established secondary prevention. Females with coronary artery disease have historically been associated with lower rates of goal directed medical therapy. Hypothesis: Disparities in statin prescriptions and targeted reductions in LDL levels exist between genders. Methods: A cross-sectional study was employed across the University of Pennsylvania Health System from 2018 to 2019. Electronic medical records were queried for all admitted patients diagnosed with ACS. Data was collected for age, gender, race, and lipid profiles on discharge and up to 1-year post-discharge. Results: The study population included 3386 patients of which 2264 (66.8%) were male and 1122 (33.14%) were female. At discharge after ACS event, 81.1% of males were on GDLT compared to only 71.6% females. Further, at post-discharge follow-up 65.1% males were still on GDLT compared to 58.3% of females. Rates of goal LDL < 70 mg/dL at post-discharge was 55.5% (602/1085) for males compared to 41.2% (226/548) for females. At this time, ezetimibe prescription rates for males was 7.4% and females was 6.9%. At post-discharge, interestingly, PCSK9-inhibitor prescription rates were 2.9% for females compared to 1.9% for males. Conclusions: Overall, male patients had higher rates of statin prescriptions than female patients on hospital discharge and at post-discharge follow-up. Further, less than half of female patients had LDL < 70 mg/dL at follow-up. Therefore, over half of female patients should be on further lipid lowering therapies. Yet, less than 7% of females are prescribed ezetimibe and only 2.9% are prescribed PCSK9-inhibitors. Further understanding of discrepancies in statin and non-statin prescription rates for female patients are warranted to allow for appropriate secondary ACS prevention.