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01-06-2015 | Original Paper

Gender differences in therapeutic recommendation after diagnostic coronary angiography: insights from the Coronary Angiography and PCI Registry of the German Society of Cardiology

Authors: Tobias Heer, Matthias Hochadel, Karin Schmidt, Julinda Mehilli, Ralf Zahn, Karl-Heinz Kuck, Christian Hamm, Michael Böhm, Georg Ertl, Dietrich Andresen, Steffen Massberg, Jochen Senges, Günter Pilz, Anselm K. Gitt, Uwe Zeymer

Published in: Clinical Research in Cardiology | Issue 6/2015

Abstract

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 0.93–1.04], in 67.1 vs. 66.8 % in NSTE-ACS (aOR 1.10, 1.07–1.12), and in 50.3 vs 49.4 % in stable CAD (aOR 1.07, 1.05–1.09).

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.

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Title: Gender differences in therapeutic recommendation after diagnostic coronary angiography: insights from the Coronary Angiography and PCI Registry of the German Society of Cardiology
Authors: Tobias Heer
Matthias Hochadel
Karin Schmidt
Julinda Mehilli
Ralf Zahn
Karl-Heinz Kuck
Christian Hamm
Michael Böhm
Georg Ertl
Dietrich Andresen
Steffen Massberg
Jochen Senges
Günter Pilz
Anselm K. Gitt
Uwe Zeymer
Publication date: 01-06-2015
Publisher: Springer Berlin Heidelberg
Published in: Clinical Research in Cardiology / Issue 6/2015
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-015-0815-6

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Conclusions

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