Women With Obstructive Hypertrophic Cardiomyopathy Are Less Likely to Receive Treatment

Among patients with obstructive hypertrophic cardiomyopathy (oHCM), females are considerably less very likely to be approved beta blockers and angiotensin-changing enzyme (ACE) inhibitors or have an implantable cardioverter-defibrillator in contrast with men. These conclusions were being revealed in BMJ Open up.

A retrospective observational analyze utilised info from the MarketScan Business Promises and Encounters Databases from IBM Watson Wellbeing to detect sufferers with much more than 1 claim with an Worldwide Statistical Classification of Ailments, Tenth Revision (ICD-10), medical modification diagnosis code of oHCM from 2016 to 2018. The scientists sought to appraise intercourse variations in demographic and clinical properties, treatment plans, and results for people with oHCM.

A whole of 9306 people with oHCM were provided (60.5{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} gentlemen, P <.001). Women had a mean age of 50±15 years compared with 49±15 years for men (P <.001).

Continue Reading

Women more frequently had hypertension (44.4{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 41.7{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.012), diabetes (15.6{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 13.5{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.005), and stroke (1.9{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 1.3{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.038) but were less likely to have dyslipidemia (18.7{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 22.3{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P <.001) and coronary artery disease (9.2{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 11.2{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.002), compared with men.

Women were also less likely to be prescribed beta blockers (42.7{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 45.2{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.017), ACE inhibitors (9.9{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 12.3{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.001), and anticoagulants (6.9{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 8.9{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.001) or have an implantable cardioverter-defibrillator (1.7{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 2.6{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.005), compared with men.

The rates of alcohol septal ablation (ASA) and myectomy were not statistically significant between women and men, respectively (ASA, 0.08{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 0.05{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.600 SM, 0.35{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 0.18{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.096).

Women were less likely to be diagnosed with atrial fibrillation (6.7{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 9.9{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P <.001) and ventricular tachycardia or fibrillation (6.1{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 8.1{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, P =.001), compared with men.

Among several study limitations, MarketScan only includes individuals with private insurance. Also, the analysis did not account for continuing enrollment of patients, and some patients may have disenrolled during the study period. The investigators were also unable to obtain specific clinical data and distinguish among diagnostic characteristics.

“The results of this analysis may aid providers in the treatment of women with oHCM, and future studies using large, clinical real-world evidence are warranted to understand the root cause of these potential treatment disparities in women with oHCM,” the study authors wrote.

Reference

Butzner M, Leslie D, Cuffee Y, Hollenbeak CS, Sciamanna C, Abraham TP. Sex differences in clinical outcomes for obstructive hypertrophic cardiomyopathy in the USA: a retrospective observational study of administrative claims data. BMJ Open. Published online March 9, 2022. doi:10.1136/ bmjopen-2021-058151