Gender differences in presentation, coronary intervention, and outcomes of 28,985 acute coronary syndrome patients in Victoria, Australia
Journal article
Worrall-Carter, Linda, McEvedy, Samantha Marie, Wilson, Andrew and Rahman, Muhammad Aziz. (2016). Gender differences in presentation, coronary intervention, and outcomes of 28,985 acute coronary syndrome patients in Victoria, Australia. Women's Health Issues. 26(1), pp. 14 - 20. https://doi.org/10.1016/j.whi.2015.09.002
Authors | Worrall-Carter, Linda, McEvedy, Samantha Marie, Wilson, Andrew and Rahman, Muhammad Aziz |
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Abstract | Background: Differences in demographics, presenting characteristics, and treatment of heart disease in women may contribute to adverse outcomes. The purpose of this paper was to describe gender differences in the epidemiology, treatment, and outcomes of all admissions for acute coronary syndrome (ACS) in Victoria that occurred between June 2007 and July 2009. Methods We undertook a retrospective cohort study of all patients admitted to Victorian hospitals with a first time diagnosis of ACS. Use of angiograms, percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and adverse outcomes (death and/or unplanned readmission) were compared by gender and hierarchical logistic regression models were used to account for confounding variables. Results Of a total of 28,985 ACS patients, 10,455 (36%) were women. Compared with men, women were older (aged ≥75 years: 54% vs 31%; p < .001), more likely to present with multiple comorbidities (>1 comorbidity: 53% vs 46%; p < .001), and more likely to be diagnosed with non–ST-segment elevation ACS (86% vs 80%; p < .001). Women were less likely to receive coronary interventions (angiogram: adjusted odds ratio [aOR], 0.71; 95% CI, 0.66–0.75; PCI: aOR, 0.73; 95% CI, 0.66–0.80; CABG: aOR, 0.58; 95% CI, 0.53–0.64). Adverse outcomes were similar in women and men after accounting for confounding variables. Conclusions Our results show that women in Victoria were less likely to receive coronary interventions after an admission for ACS. Clinicians should be wary of inherent gender bias in decisions to refer patients for angiography. |
Year | 2016 |
Journal | Women's Health Issues |
Journal citation | 26 (1), pp. 14 - 20 |
Publisher | Elsevier Inc. |
ISSN | 1049-3867 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.whi.2015.09.002 |
Scopus EID | 2-s2.0-84958549093 |
Page range | 14 - 20 |
Research Group | Mary MacKillop Institute for Health Research |
Publisher's version | File Access Level Controlled |
Place of publication | United States |
https://acuresearchbank.acu.edu.au/item/85z72/gender-differences-in-presentation-coronary-intervention-and-outcomes-of-28-985-acute-coronary-syndrome-patients-in-victoria-australia
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