UNDERUTILIZATION OF THROMBOLYTIC THERAPY IN ELIGIBLE WOMEN WITH ACUTE MYOCARDIAL-INFARCTION

New methods for the management of coronary artery disease are almost always evaluated in male patients or in groups of patients who are predominantly male.1 This bias is in part due to the fact that men develop coronary artery disease more frequently and at an earlier age than do women.2 This problem is compounded by the usual practice of excluding elderly patients from therapeutic trials. Most trials of thrombolytic therapy for acute myocardial infarction (AMI) have an upper age limit of 70 or 75 years, as was the case in our own trials.3 Because thrombolytic therapy has been largely evaluated in men, we have been concerned that once this therapy was demonstrated to be effective, it might be preferentially applied. In this analysis, we attempt to specify the role of gender in the eligibility for and use of thrombolytic therapy. © 1991.