News in brief: Women less likely to receive treatment for cardiogenic shock; Covid curbs pharma sponsorship of doctor meetings; One in 10 AF patients have readmissions;


Women less likely to receive treatment for cardiogenic shock

Women are less likely to receive lifesaving treatment for cardiogenic shock than men, despite having similar clinical characteristics, Danish research shows.

A retrospective study of 1,716 heart attack patients with cardiogenic shock, found that significantly lower proportions of women received mechanical circulatory support (19% women versus 26% men), minimally invasive or surgical procedures to restore blood flow to blocked arteries (83% vs 88%), and mechanical ventilation (67% vs 82%).

Women were significantly less likely than men to survive in the short- and long-term. At 30 days after the heart event, just 38% of women were alive compared with 50% of men. At 8.5 years, 27% of women were alive compared with 39% of men.

The findings, presented at a European Society of Cardiology (ESC) meeting, showed that women and men had comparable clinical parameters such as blood pressure, heart rate, plasma lactate and left ventricular ejection fraction.

One in four of the patients in the study were women and the average age of women in the study was 71 years compared with 66 years for men.

Women were significantly more likely than men to be initially admitted to a local hospital (41% women versus 30% men), while significantly more men presented with out-of-hospital cardiac arrest (25% women versus 48% men).

Study investigator Dr Sarah Holle of Copenhagen University Hospital, Rigshospitalet, said there was increasing evidence that women with acute heart problems were more likely than men to have non-specific symptoms such as shortness of breath, nausea, vomiting, coughing, fatigue, and pain in the back, jaw or neck.

“This might be one reason why more women than men in our study were initially admitted to a local, rather than specialist, hospital. Increased recognition that women may have symptoms other than chest pain could minimise delays in diagnosis and treatment and potentially improve prognosis.”


Covid curbs pharma sponsorship of doctor meetings

Pharmaceutical industry spending on hospitality for doctors attending medical education events fell by 40% during the pandemic, according to new figures released by industry lobby group Medicines Australia.

In its transparency report for the period 1 November 2020 to 30 April 2021 the total expenditure reported by companies on hospitality was $364,332, down from $594,474.

There were 721 medical education events sponsored during the six month period at a total costs of $5.96 million covered by the report, compared to spending of $5.63 million on 804 events in the same period a year previously.

The total hours of education supported by industry sponsorship declined from 6253 hours to 4934 hours.

The number of healthcare professional attendances at industry sponsored events fell from 165,455 to 148,810.

The pandemic forced most medical meetings to be transformed into virtual meetings and a recent pharmaceutical industry survey showed that most companies expected a significant level of virtual engagement with healthcare professionals to be maintained in future.


One in 10 AF patients have unplanned readmissions

Almost one in ten patients hospitalised for atrial fibrillation has an unplanned readmission within a month, Australian figures show.

A review of data for 301,654 patients hospitalised for AF, of which two thirds were acute presentations showed that 29,750 (9.9%) experienced an unplanned readmission within 30 days.

The figures derived from AF hospitalisations between 2010 to 2015 at all public and most private hospitals in Australia and New Zealand, also showed that 63% of unplanned readmissions occurred within 14 days.

Unplanned readmissions were more likely to occur following an acute versus elective AF hospitalisations (12.5% vs 4.9%).

The most common reasons for readmissions were recurrence of AF (33.2%), and preventable conditions including heart failure (9.0%) and  pneumonia (2.4%) and acute myocardial infarction  (1.7%).

“Improved clinical management of AF and transitional care planning are required to reduce unplanned readmissions following AF hospitalisations,” said the study authors in Heart Lung and Circulation.

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