Abstract
Cardiovascular diseases (CVDs) are the leading cause of death in Poland. Starting from 1992, a gradual decrease in mortality due to CVDs has been observed, which is less noticeable in women. Following this notion, we assessed sex differences in the implementation of ESC recommendations regarding lipid control and the use of statins as part of secondary CVDs prevention in 1236 patients with acute coronary syndrome or elective coronary revascularization within the last 6–24 months. During hospitalization women had more frequently abnormal TC levels than men (p = 0.035), with overall higher TC levels (p = 0.009) and lower HDL-C levels (p = 0.035). In the oldest group, they also had more frequently elevated LDL-C levels (p = 0.033). Similar relationships were found during the follow-up visit. In addition, women less often achieved the secondary lipid therapeutic goal for non-HDL-C (p = 0.009). At discharge from hospital women were less frequently prescribed statins (p = 0.001), which included high-intensity statins (p = 0.002). At the follow-up visit the use of high-intensity statins was still less frequent in women (p = 0.02). We conclude that women generally have less optimal lipid profiles than men and are less likely to receive high-intensity statins. There is a need for more organized care focused on the management of risk factors.
Highlights
As a high-intensity statin therapy, we considered the use of atorvastatin ≥ 40 mg or rosuvastatin ≥ 20 mg
Patients with ACS accounted for 64% and 58% of the female and male groups, respectively, with acute myocardial infarction occurring in 39% of women and 39%
Lipid disorders are a major risk factor of Cardiovascular diseases (CVDs), whose high prevalence in the general population has been confirmed in a number of reports [23,24]
Summary
While in 2016 the death rate due to CVDs per 100,000 population was clearly higher in women than in men (457.2 vs 415.7) [1], the European Society of Cardiology (ESC) guidelines for secondary prevention of ischemic heart disease are the same for both sexes [2]. For both groups, experts issue the same recommendations for lifestyle changes, treatment of comorbidities, use of cardioprotective drugs and invasive coronary artery disease (CAD) treatment therapies. Numerous studies have shown a greater number of complications after coronary revascularization procedures in women [4,5,6]
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