Narrowing sex differences in pharmacotherapy following invasive angiography for coronary artery disease between 2017 and 2024

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ID: 316414
2026
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Abstract
Abstract Women who experience myocardial infarction (MI) and undergo invasive angiography, experience higher morbidity and mortality compared to age-matched male counterparts. The prognostic benefit of optimal medical therapy (OMT) following MI is well established, however treatment bias has been evidenced historically between the sexes. We explored sex differences in prescribing trends of OMT following invasive angiography for obstructive CAD at a high throughput regional cardiac centre. We determined discharge medication received by females and males undergoing invasive angiography in 2017, 2019, 2022 and 2024 with obstructive CAD (angiographic lesion ≥50% luminal diameter). Logistic regression was used to determine differences in the main cohort and in sub-groups by clinical diagnosis (ACS, STEMI, NSTEMI, stable angina) and age (< 55 or ≥55 years). This latter age cut-off to explore pre and post-menopause trends, respectively. 10,591 patient attendances (22.3% female, n=2,360) were included in the analysis. In the overall cohort women were less likely to receive β-blockers (P=0.002), ACE-I/ARB (P=0.002) and high potency P2Y12 inhibitors (P<0.001) compared to males. In ACS similar patterns were observed for β-blockers and high potency P2Y12 inhibitors, women ≥55 years were less likely to receive high intensity statin (HIS). However, we show significant improvements in the prescribing of β-blockers (P=0.018) in women over time, and a trend towards improved prescribing of high potency P2Y12 inhibitors (P=0.085) in ACS. These findings demonstrate welcome improvements in equitable prescribing practices for OMT post angiography and highlight the importance of reviewing prescribing practices to ensure evidencing of success in implementing best practice guidelines.
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openalex_W7163916073 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Andrew J Sullivan, Zin Tun, Margaret Siu, M Rai, G Antoun, Nandini Rawat, R Walker, Alexandros Kythreotis, Abdelmajid Al Jariri, Asad Shabbir, Shane Cashin, Anthony Mathur, D A Jones, Ajay Gupta, Krishnaraj Rathod, Amrita Ahluwalia
Journal European Heart Journal Open
Year 2026
DOI
10.1093/ehjopen/oeag099
URL
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