|Coronary artery bypass graft surgery and primary percutaneous coronary intervention choices in patients with similar coronary anatomy: A computer-based simulation examines the sex gap.|
|PMID: 19898697 Owner: NLM Status: MEDLINE|
|BACKGROUND: Sex differences (or a 'sex gap') exist in the rates of cardiac revascularization. It was evaluated whether physician preference contributes to this difference.
OBJECTIVES: To obtain information on how cardiac specialists manage male and female patients being evaluated for coronary artery disease.
METHODS: A computer-based patient simulation program was developed. Six sex-matched clinical vignettes (three pairs) with uninterpreted coronary angiograms were shown to specialists, who were blinded to the purpose of the study. The sex-matched scenarios were balanced with respect to symptoms, comorbidities and coronary anatomy. Physicians were surveyed on management and rationale.
RESULTS: Fifty physicians were surveyed, consisting mainly of cardiologists from tertiary cardiac centres in Ontario. Among the three sexmatched pairs, the frequencies at which percutaneous coronary intervention (including drug-eluting stents), bypass surgery and medical therapy were chosen did not differ across sexes. The means for men and women, respectively, were 47% and 50% for percutaneous coronary intervention, 32% and 26% for bypass surgery, and 21% and 24% for medical treatment.
CONCLUSIONS: In the present pilot study, cardiac specialists chose similar rates of medical, interventional and surgical procedures independent of a patient's sex. Although large registry trials show that sex differences in management exist, the present data suggest that cardiac specialist preference is less likely to be a factor if coronary angiography was performed. Further research is required to explore the causes of sex discrepancies in cardiac care.
|B M Meyers; T Vira; Chi- Ming Chow; B L Abramson|
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|Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't|
|Title: The Canadian journal of cardiology Volume: 25 ISSN: 1916-7075 ISO Abbreviation: Can J Cardiol Publication Date: 2009 Nov|
|Created Date: 2009-11-09 Completed Date: 2009-12-01 Revised Date: 2013-05-31|
Medline Journal Info:
|Nlm Unique ID: 8510280 Medline TA: Can J Cardiol Country: Canada|
|Languages: eng Pagination: 649-53 Citation Subset: IM|
|St Michael's Hospital, University of Toronto, Toronto, Canada.|
|APA/MLA Format Download EndNote Download BibTex|
Angioplasty, Balloon, Coronary / standards*, trends
Attitude of Health Personnel
Cardiology / standards, trends
Coronary Artery Bypass / standards*, trends
Coronary Artery Disease / mortality*, radiography, therapy*
Health Care Surveys
Physician's Practice Patterns / standards, trends
Quality of Health Care
Severity of Illness Index
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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