Sex Differences in Cardiac Risk Factors, Perceived Risk, and Health Care Provider Discussion of Risk and Risk Modification Among Young Patients With Acute Myocardial Infarction: The VIRGO Study.
Sex Differences in Cardiac Risk Factors, Perceived Risk, and Health Care Provider Discussion of Risk and Risk Modification Among Young Patients With Acute Myocardial Infarction: The VIRGO Study.
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DOI：
10.1016/j.jacc.2015.08.859
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发表时间：
2015-11-03
影响因子：
24
通讯作者：
Lichtman JH
中科院分区：
文献类型：
--
作者：
Leifheit-Limson EC;D'Onofrio G;Daneshvar M;Geda M;Bueno H;Spertus JA;Krumholz HM;Lichtman JH
心脏危险因素、对心脏危险的认识以及医疗保健提供者对急性心肌梗死（AMI）风险的讨论的性别差异尚未得到充分研究。我们比较了年轻女性和男性急性心肌梗死患者的心脏危险因素患病率、风险认知和医疗保健提供者对心脏病和风险调整的反馈。我们研究了2008年8月至2012年1月在美国和西班牙医院参加VIRGO研究的3，501例年龄在18-55岁之间的AMI患者，比较了5种心脏危险因素的患病率。改良泊松回归被用来评估自我感知的心脏病风险和自我报告的供应商讨论的风险和修改的性别差异。几乎所有患者（98%）有≥ 1个风险因素，64%有≥ 3个风险因素。只有53%的患者认为自己有患心脏病的风险，更少的患者被告知他们有风险（46%），或者他们的医疗保健提供者讨论了心脏病和风险调整（49%）。女性比男性更不可能被告知他们有风险（相对风险[RR] 0.89，95%置信区间[CI] 0.84-0.96）或有提供者讨论风险修改（RR 0.84，95% CI 0.79-0.89）;女性和男性之间的自我感知风险没有差异。尽管存在显著的心脏风险因素，但只有一半的年轻AMI患者在事件发生前认为自己有心脏病风险。更少的人与他们的医疗保健提供者讨论他们的风险或风险修改;这个问题在女性中更为明显。
Differences between sexes in cardiac risk factors, perceptions of cardiac risk, and healthcare provider discussions about risk with acute myocardial infarction (AMI) are not well studied. We compared cardiac risk factor prevalence, risk perceptions, and healthcare provider feedback on heart disease and risk modification between young women and men hospitalized with AMI. We studied 3,501 AMI patients aged 18-55 years enrolled in the VIRGO study in US and Spanish hospitals between 8/2008 to 1/2012, comparing the prevalence of 5 cardiac risk factors by sex. Modified Poisson regression was used to assess sex differences in self-perceived heart disease risk and self-reported provider discussions of risk and modification. Nearly all patients (98%) had ≥ 1 risk factor, and 64% had ≥ 3. Only 53% of patients considered themselves at-risk for heart disease, and even fewer reported being told they were at-risk (46%) or that their healthcare provider discussed heart disease and risk modification (49%). Women were less likely than men to be told they were at-risk (relative risk [RR] 0.89, 95% confidence interval [CI] 0.84-0.96) or have a provider discuss risk modification (RR 0.84, 95% CI 0.79-0.89); there was no difference between women and men for self-perceived risk. Despite significant cardiac risk factors, only half of young AMI patients believed they were at-risk for heart disease before their event. Even fewer discussed their risks or risk modification with their healthcare providers; this problem was more pronounced among women.