Document Detail

Referral for coronary artery revascularization procedures after diagnostic coronary angiography: evidence for gender bias?
MedLine Citation:
PMID:  7759719     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to determine whether there is a gender bias in the selection of patients for coronary revascularization once the severity of the underlying coronary artery disease has been established with angiography. BACKGROUND: It has been suggested that women with coronary artery disease are less likely to be referred for coronary angiography and coronary artery bypass surgery than men. Whether such a referral bias for revascularization procedures, including coronary angioplasty, is present once angiography has been performed is not clear. METHODS: We retrospectively analyzed 22,795 patients with suspected coronary artery disease who underwent coronary angiography between 1981 and 1991 and compared the numbers of women and men who underwent either coronary artery bypass surgery or coronary angioplasty within 30 days of coronary angiography. RESULTS: Angiography revealed significant (one-vessel or more) disease in 15,455 patients (52% of women, 76% of men). Despite worse symptoms, women had less extensive coronary disease than men as judged by the number of vessels diseased. Women were also more likely to have other co-morbid diseases. An equal proportion of women (54%) and men underwent revascularization procedures. After adjustment for baseline differences and age, differences in the two individual revascularization strategies were very small: More women tended to have coronary angioplasty ([absolute difference +/- 1 SD] + 3.3 +/- 0.7%, p < 0.0001), but fewer had coronary artery bypass surgery than men (-2.5 +/- 0.8%, p = 0.003). When the two revascularization strategies were considered together, there was no significant gender difference in overall adjusted use of revascularization (+ 0.8 +/- 0.9%, p = 0.41). CONCLUSIONS: Once diagnostic coronary angiography had been performed, no major differences in the overall utilization of revascularization procedures were noted for women compared with men.
M R Bell; P B Berger; D R Holmes; C J Mullany; K R Bailey; B J Gersh
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  25     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-06-23     Completed Date:  1995-06-23     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1650-5     Citation Subset:  AIM; IM    
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Coronary Angiography / statistics & numerical data*
Coronary Disease / epidemiology*,  radiography,  therapy
Linear Models
Middle Aged
Myocardial Revascularization / statistics & numerical data,  utilization*
Referral and Consultation / statistics & numerical data*
Retrospective Studies
Sex Distribution
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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