110 SEX AND RACE BASED DIFFERENCES IN THE UTILIZATION OF LIPID LOWERING MEDICATIONS AFTER ACUTE MYOCARDIAL INFRACTION

Introduction Despite the benefits of lipid-lowering therapy after acute myocardial infarction, this treatment is presently underutilized. This study aimed to assess the role of sex and race on utilization of lipid-lowering medications at discharge in a current national sample of patients hospitalized with acute myocardial infarction. Methods and Results This was a cross sectional study in which demographic, procedural, and discharge medication data were collected from 138,001 patients with acute myocardial infarction discharged from 1,470 U.S. hospitals participating in the National Registry of Myocardial Infarction 3 from July 1998 to June 1999. Lipid-lowering medications were part of the discharge regimen in 31.7%. Women were less likely to be treated with lipid lowering medications, with only 26.8% being discharged on treatment as compared to 34.8% of men (odds ratio [OR] 0.69 95% CI 0.67-0.70). Black patients were less likely to be treated, with 28.9% treated in contrast to 31.9% of the non-black patients (OR 0.87, 95% CI 0.83-0.91). Treatment rates in black females were slightly higher than non-Black females (28.2% vs. 26.7%), but Black males were significantly less likely to be treated (29.5% vs. 35.1%, P≤0.0001). In multivariate analysis, factors independently related to decreased lipid-lowering utilization included female sex (OR 0.97, 0.94-1.00), black (OR 0.94, 95% CI 0.89-0.93) and older age (age 65-74 compared to ≤ 55; OR 0.82, 95% CI 0.78-0.86). Conclusion Analysis of current practice patterns in patients hospitalized with acute myocardial infarction reveal significant sex and racial differences in the utilization of lipid-lowering medications at time of discharge.