ESC Congress 2026 Abstract · Oct 26, 2026

Sex differences in the treatment with statins after myocardial infarction in denmark: a time-trend study utilising national registries

By Andersen A, Sodergren STF, Modin D et al.

Background: Several studies have reported differences between women and men in statin treatment after myocardial infarction (MI), even though efficacy and safety are comparable and clinical guidelines recommend treatment equally for both sexes. Purpose: To examine sex differences and temporal trends in statin treatment initiation after MI by age and calendar year using nationwide register data with near complete population coverage. Methods: We used nationwide registers to identify all patients hospitalised with a first-time MI between January 1st, 2000, and December 31st, 2024, in Denmark. MI patients were identified by the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) code I21 (both primary and secondary diagnosis). Patients with a redeemed statin prescription within 180 days before MI were excluded. Statin initiation was defined as at least one redeemed prescription within 180 days after MI. Analyses were stratified by sex, age, and calendar period. Age was categorised into six groups (18–39, 40–49, 50–59, 60–69, 70–79, and ≥80 years), and calendar year of MI was grouped into five periods (2000–2004, 2005–2009, 2010–2014, 2015–2019, and 2020–2024). Continuous variables were presented as medians (IQR) and categorical variables as counts (percentages). Differences between groups were assessed using chi-square, Wilcoxon rank-sum, and log-rank tests as appropriate, with time-to-treatment evaluated using Kaplan–Meier analyses. Results: 154,591 patients were included in the study (37% women, median age 75 years for women and 65 years for men). Women had a higher baseline prevalence of cardiovascular disorders and redeemed more prescriptions for anti-hypertensive drugs, beta-blockers and aspirin compared to men (Table 1). The relative difference between women and men widened from 11 percentage points in 2000–2004 to 17 percentage points in 2015–2019, followed by a modest reduction to 15 percentage points in 2020–2024. Across all year intervals, women 40 years or above were consistently treated less than males (p<0.001 for all). In patients 18-39 years, the relative treatment difference between women and men increased substantially over time, rising from 3% in 2000-2004 to 36% in 2020-2024, with the largest treatment differences occurring from 2010 onwards. A decrease in the relative proportional differences in treatment initiation between women and men was found from 2015-2019 to 2020-2024 in all age groups (Figure 1). Conclusion: Women received less statins than men after a MI despite guideline recommendations. Disparities in treatment persisted and grew over the years, but this trend seems to have been reversing in the last few years.Figure 1Table 1

doi.org/10.1093/eurheartj/ehag785.3744Open accessPopulations