Impact of comorbidities and gender on the use of coronary interventions in patients with high-risk non-ST-segment elevation acute coronary syndrome
Journal article
Worrall-Carter, Linda, McEvedy, Samantha, Wilson, Andrew and Rahman, Muhammad Aziz. (2016). Impact of comorbidities and gender on the use of coronary interventions in patients with high-risk non-ST-segment elevation acute coronary syndrome. Catheterization and Cardiovascular interventions. 87(4), pp. E128 - E136. https://doi.org/10.1002/ccd.26117
Authors | Worrall-Carter, Linda, McEvedy, Samantha, Wilson, Andrew and Rahman, Muhammad Aziz |
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Abstract | Objectives: To determine the impact of gender and comorbidity on use of coronary interventions in patients diagnosed with high-risk non-ST-segment acute coronary syndrome (NSTEACS). Background: Guidelines recommend the use of coronary angiography for all patients diagnosed with NSTEACS with high-risk features, except in the presence of severe comorbidities. However, little is understood about the relationship between gender, comorbidity, and the use of coronary interventions. Methods: Retrospective analyses of the Victorian Admitted Episodes Data Set (VAED) including all patients diagnosed with NSTEACS with high-risk features on their first admission for ACS between June 2007 and July 2009. Hierarchical logistic regression models and correspondence analyses were used to understand the relationship between gender, comorbidities, and the use of coronary interventions. Results: Out of 16,771 NSTEACS patients with high-risk features, 6,338 (38%) were female. Females were older than males (aged ≥75: 62% vs 39%, p < 0.001) and more likely to have multiple comorbidities (≥2: 66% vs 59%, p < 0.001). After adjusting for potential confounders, females were more likely to receive no coronary intervention than males with a similar number of comorbid conditions (no comorbidities: OR 1.62, 95% CI 1.28–2.05; 1 comorbidity: OR 1.67, 95% CI 1.44–1.93; 2 comorbidities: OR 1.93, 95% CI 1.66–2.23; ≥3 comorbidities: OR 1.42, 95% CI 1.27–1.60). Conclusions: Lower rates of coronary intervention in females persisted after adjusting for number of comorbidities which suggests that gender may bias decisions regarding referral for coronary intervention in high-risk NSTEACS independent of other factors. © 2015 Wiley Periodicals, Inc. |
Keywords | coronary heart disease; women; angiogram; percutaneous coronary intervention; correspondence analysis |
Year | 2016 |
Journal | Catheterization and Cardiovascular interventions |
Journal citation | 87 (4), pp. E128 - E136 |
Publisher | John Wiley & Sons, Inc. |
ISSN | 1522-1946 |
Digital Object Identifier (DOI) | https://doi.org/10.1002/ccd.26117 |
Scopus EID | 2-s2.0-84940194812 |
Page range | E128 - E136 |
Research Group | Mary MacKillop Institute for Health Research |
Publisher's version | File Access Level Controlled |
Place of publication | United States of America |
https://acuresearchbank.acu.edu.au/item/8q0y7/impact-of-comorbidities-and-gender-on-the-use-of-coronary-interventions-in-patients-with-high-risk-non-st-segment-elevation-acute-coronary-syndrome
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