{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:57:11Z","timestamp":1788919031604,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,5,11]],"date-time":"2018-05-11T00:00:00Z","timestamp":1525996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"American Heart Association Get With The Guidelines"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Sex\u2010based differences in acute coronary syndrome (ACS) mortality may attenuate with age due to better symptom recognition and prompt care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Age is a modifier of temporal trends in sex\u2010based differences in ACS care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among 104\u2009817 eligible patients with ACS enrolled in the AHA Get With the Guidelines\u2013Coronary Artery Disease registry between 2003 and 2008, care and in\u2010hospital mortality were evaluated stratified by sex and age. Temporal trends within sex and age groups were assessed for 2 care processes: percentage of STEMI patients presenting to PCI\u2010capable hospitals with a DTB time\u2009\u2264\u200990\u2009minutes (DTB90) and proportion of eligible ACS patients receiving aspirin within 24\u2009hours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After adjustment for clinical risk factors and sociodemographic and hospital characteristics, 2276 (51.7%) women and 6276 (56.9%) men with STEMI were treated with DTB90 (adjusted OR: 0.85, 95% CI: 0.80\u20130.91, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 for women vs men). Time trend analysis showed an absolute increase ranging from 24% to 35% in DTB90 rates among both men and women (<jats:italic>P<\/jats:italic> for trend &lt;0.0001 for each group), with consistent differences over time across the 4 age\/sex groups (3\u2010way <jats:italic>P<\/jats:italic>\u2010interaction\u2009=\u20090.93). Despite high rate of baseline aspirin use (87%\u201391%), there was a 9% to 11% absolute increase in aspirin use over time, also with consistent differences across the 4 age\/sex groups (all 3\u2010way <jats:italic>P<\/jats:italic>\u2010interaction \u22650.15).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Substantial gains of generally similar magnitude existed in ACS performance measures over 6\u2009years of study across sex and age groups; areas for improvement remain, particularly among younger women.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22938","type":"journal-article","created":{"date-parts":[[2018,3,9]],"date-time":"2018-03-09T12:02:53Z","timestamp":1520596973000},"page":"758-768","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Sustained sex\u2010based treatment differences in acute coronary syndrome care: Insights from the American Heart Association Get With The Guidelines Coronary Artery Disease Registry"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7402-9584","authenticated-orcid":false,"given":"Jacob A.","family":"Udell","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Women's College Hospital and Peter Munk Cardiac Centre, Toronto General Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3192-8093","authenticated-orcid":false,"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ahmanson\u2010UCLA Cardiomyopathy Center University of California  Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Maddox","sequence":"additional","affiliation":[{"name":"Division of Cardiology Washington University School of Medicine  St. Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Heart &amp; Vascular Center and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Frank Peacock","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Baylor College of Medicine  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren K.","family":"Laskey","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine University of New Mexico Health Sciences Center  Albuquerque"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria V.","family":"Grau\u2010Sepulveda","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric E.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Cumming School of Medicine University of Calgary  Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian F.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke Medical Center  Durham North Carolina"},{"name":"Division of Cardiology Duke University School of Medicine  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke Medical Center  Durham North Carolina"},{"name":"Division of Cardiology Duke University School of Medicine  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":false,"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Heart &amp; Vascular Center and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Get With The Guidelines Steering Committee and Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.18.2054"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199907223410402"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004319"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.199"},{"key":"e_1_2_8_6_1","first-page":"1863","article-title":"Karp I, et al; GENESIS\u2010PRAXY Team. 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