That finding, presented at the Annual Scientific Session of the American College of Cardiology, comes from an analysis of records from 2,857 heart attack survivors treated at Michigan hospitals before and after a major quality improvement effort took place. All were insured under Medicare.

The researchers, led by a team from the University of Michigan Cardiovascular Center, found a significant difference between the treatment women received before and after the effort, and that received by men. The increased use of proven medications, for example, was much more pronounced in men.

Overall, both men and women treated in the four months after the quality effort began had a better chance of being alive a year after their hospital stay ended. But women didn't get as much mortality reduction benefit as men.

That difference may be in part because women patients were less likely than men to have a one-on-one session with doctors or nurses before they went home, to help them understand and "take charge" of the medicines and lifestyle changes that could improve their health. Both men and women who had this session, and signed a discharge contract with their doctors and nurses that included a pledge to stick to treatment and follow-up appointments, lived longer than those who didn't.

"We're troubled by the gender differences we found, though we remain encouraged by the overall effect of post-heart attack quality improvement efforts," says lead researcher Kim Eagle, M.D., clinical director of the U-M Cardiovascular Center.

Eagle is co-director of the Guidelines Applied in Practice (GAP) Project in Michigan. GAP is a project of the ACC that aims to help hospitals deliver proven medications, tests, and advice on diet, exercise, smoking cessation and weigh
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
9-Mar-2005