Sex Differences in the Benefits of the Guidelines Applied in Practice Project: Are They Due to Sex?

We read with great interest the study by Jani et al¹ that examined the relative efficacy of the Guidelines Applied in Practice (GAP) program in men vs women with acute myocardial infarction.

A previous analysis of the GAP projects in Michigan demonstrated that, overall, use of the discharge tool was independently associated with a lower 1-year mortality rate (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.36-0.76; P<.001).² In the sex-specific analysis by Jani et al,¹ women treated with the discharge tool had a significant reduction in 1-year mortality (OR, 0.46; 95% CI, 0.27-0.79; P = .005), while only a trend toward benefit was observed in men (OR, 0.62; 95% CI, 0.36-1.06; P = .08).