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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• 作者：Tobias Heer ; Matthias Hochadel ; Karin Schmidt…
• 关键词：Gender differences ; Women ; Coronary angiography ; Coronary artery disease
• 刊名：Clinical Research in Cardiology
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：104
• 期：6
• 页码：507-517
• 全文大小：592 KB
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• 作者单位：Tobias Heer (1)
  Matthias Hochadel (2)
  Karin Schmidt (3)
  Julinda Mehilli (4)
  Ralf Zahn (3)
  Karl-Heinz Kuck (5)
  Christian Hamm (6)
  Michael B?hm (7)
  Georg Ertl (8)
  Dietrich Andresen (9)
  Steffen Massberg (4)
  Jochen Senges (2)
  Günter Pilz (1)
  Anselm K. Gitt (2) (3)
  Uwe Zeymer (2) (3)
  
  1. Department of Cardiology, Krankenhaus Agatharied, Academic Teaching Hospital, University of Munich, Norbert-Kerkel-Platz, 83607, Hausham, Germany
  2. Stiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
  3. Medizinische Klinik B, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany
  4. Medizinische Klinik I, Klinikum der Ludwig-Maximilians-Universit?t München, Munich, Germany
  5. Asklepios Klinik St. Georg Hamburg, Hamburg, Germany
  6. Kerckhoff Klinik Bad Nauheim, Bad Nauheim, Germany
  7. Universit?tsklinikum des Saarlandes, Homburg/Saar, Germany
  8. Medizinische Klinik und Poliklinik I, Comprehensive Heart Failure Center, Universit?tsklinikum Würzburg, Würzburg, Germany
  9. Vivantes Klinikum Am Urban, Berlin, Germany
  
• 刊物主题：Cardiology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1861-0692

文摘

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-.04], in 67.1 vs. 66.8?% in NSTE-ACS (aOR 1.10, 1.07-.12), and in 50.3 vs 49.4?% in stable CAD (aOR 1.07, 1.05-.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.