Grant: Project Grant

Women still struggle to achieve high-quality equitable cardiovascular care. Recently, there has been growing attention to young women (=55 years) with acute coronary syndrome (ACS), who experience worse recoveries and higher mortality compared with similar aged men. Moreover, the rising incidence of ACS in young is of immediate concern. Despite recent advancements in understanding premature ACS outcomes, important questions remain. Access to high-quality care which may differ across health care systems (private/public) could explain the suboptimal care and poorer outcomes in young women post-ACS. Gender-related factors (e.g. socioeconomic status) have been associated with poorer access to timely cardiac procedures among women, independent of sex. The impact of sex and gender on access to care along the continuum of care for premature ACS, including how it varies across health care systems requires further investigation. Accordingly, our objective is to examine sex differences in the trajectory of access to care from pre-ACS to post-ACS setting among young patients and whether gender-related factors are associated with access to care. We hypothesize that female sex and gender-related factors traditionally ascribed to women are associated with poorer access to care in young and the magnitude of such disparities depends on health care system. To test this, we will merge data on two largest prospective cohorts of young patients with premature ACS to date: GENESIS-PRAXY and VIRGO studies. A sex and gender-based approach to address the unmet health care needs of premature ACS is much needed. It will help identify factors for targeted interventions aimed at improving women's access to high-quality health care. Merging these cohorts across 4 countries (US, Canada, Spain, Switzerland) will provide an opportunity for high-impact international research on sex and gender differences on access to care and for accessing the generalizability of results across health care systems.