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Clin Res Cardiol. 2015 Jun;104(6):507-17. doi: 10.1007/s00392-015-0815-6. Epub 2015 Jan 21.

Gender differences in therapeutic recommendation after diagnostic coronary angiography: insights from the Coronary Angiography and PCI Registry of the German Society of Cardiology.

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1
Department of Cardiology, Krankenhaus Agatharied, Academic Teaching Hospital, University of Munich, Norbert-Kerkel-Platz, 83607, Hausham, Germany, tobias.heer@khagatharied.de.

Abstract

BACKGROUND:

There is information suggesting differences and underuse of invasive coronary diagnostic and therapeutic procedures in women compared to men.

METHODS:

Data from consecutive patients (pts) which were enrolled in the Coronary Angiography and PCI Registry of the German Society of Cardiology were analyzed. We compared gender-related differences in diagnosis and therapeutic recommendation of pts undergoing coronary angiography (XA) for stable coronary artery disease (CAD), non-ST elevation acute coronary syndromes (NSTE-ACS) and ST elevation myocardial infarction (STEMI).

RESULTS:

From 2004 until the end of 2009, data of 1,060,542 invasive procedures in 1,014,996 pts were prospectively registered. One-third (34.6%) of them were female. Women less often had significant CAD, irrespective of the indication for XA. In pts with relevant CAD, percutaneous coronary interventions (PCI) were recommended in 87.1% of women versus 89.1% of men with STEMI [age-adjusted OR (aOR) 0.98, 95% CI 0.93-1.04], in 67.1 vs. 66.8% in NSTE-ACS (aOR 1.10, 1.07-1.12), and in 50.3 vs 49.4% in stable CAD (aOR 1.07, 1.05-1.09).

CONCLUSIONS:

In pts with significant CAD, there was no difference in recommendation for PCI between the genders in stable CAD, whereas in STEMI and NSTE-ACS women were treated even more often with PCI. There were only minor differences in referral for CABG between women and men. Hence, our data provide strong evidence against a gender bias in use of invasive therapeutic procedures once the diagnosis of significant CAD has been confirmed.

PMID:
25875945
DOI:
10.1007/s00392-015-0815-6
[Indexed for MEDLINE]
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