Gender differences and temporal trends in clinical characteristics, stress test results and use of invasive procedures in patients undergoing evaluation for coronary artery disease

被引:70
|
作者
Miller, TD
Roger, VL
Hodge, DO
Hopfenspirger, MR
Bailey, KR
Gibbons, RJ
机构
[1] Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
[2] Mayo Clin, Div Biostat, Rochester, MN 55905 USA
关键词
D O I
10.1016/S0735-1097(01)01413-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES This study examined gender differences and temporal changes in the clinical characteristics of patients referred for nuclear stress imaging, their imaging results and subsequent utilization of coronary angiography and revascularization. BACKGROUND Gender bias may influence resource utilization in patients with coronary artery disease (CAD). No study has analyzed gender differences and time trends in patients referred for noninvasive testing and subsequent use of invasive procedures. METHODS Between January 1986 and December 1995, 14,499 patients (5,910 women and 8,589 men) without established CAD underwent stress myocardial perfusion imaging. The clinical characteristics, imaging results, coronary angiograms and revascularization outcomes were compared in women and men over time. RESULTS The mean pretest probability of CAD was lower in women (45%) than in men (70%) (p < 0.001). More women (69%) than men (42%) had normal nuclear images (p < 0.001). Men (17%) were more likely than women (8%) to undergo coronary angiography (p < 0.001). Male gender was independently associated with referral for coronary angiography (multivariate model: chi-square = 16, p < 0.001) but was considerably weaker than the imaging variables (summed reversibility score: chi-square = 273, p < 0.001). Revascularization was performed in more men (46% of the population undergoing angiography) than women (39%) (p = 0.01), but gender was not independently associated with referral to revascularization. There were no significant differences in clinical, imaging or invasive variables between the genders over time. CONCLUSIONS There was little evidence for a bias against women in this study. Women were somewhat less likely to undergo coronary angiography but were referred for stress perfusion imaging more liberally. Practice patterns remained constant over this 10-year period. (C) 2001 by the American College of Cardiology.
引用
收藏
页码:690 / 697
页数:8
相关论文
共 50 条
  • [1] Temporal Effect On Gender Differences In Patients Undergoing Evaluation For Coronary Artery Disease
    Sparano, Dina M.
    Aurora, Monika
    Kohli, Priya
    Lapin, Brittany
    O'Connell, Claire
    Johnson, Nils
    Holly, Thomas
    Gulati, Martha
    CIRCULATION, 2011, 124 (21)
  • [2] TEMPORAL EFFECT ON GENDER DIFFERENCES IN PATIENTS UNDERGOING EVALUATION FOR CORONARY ARTERY DISEASE
    Arora, Monika
    Sparano, Dina
    Johnson, Nils P.
    O'Connell, Claire
    Holly, Thomas A.
    Gulati, Martha
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2010, 55 (10)
  • [3] Gender differences in the incidence of coronary artery disease in patients with stable angina and stress test in clinical practice
    Friedrich, J
    Schneider, S
    Tebbe, U
    Gottwik, M
    Senges, J
    Zeymer, U
    EUROPEAN HEART JOURNAL, 2004, 25 : 519 - 519
  • [4] Clinical characteristics of patients undergoing coronary artery bypass surgery: Focus on gender differences
    Ozen, Gulsev
    Aljesri, Khadija
    Kizar, Oznur
    Topal, Gokce
    Turkyilmaz, Gulsum
    Turkyilmaz, Saygin
    ISTANBUL JOURNAL OF PHARMACY, 2020, 50 (03): : 153 - 159
  • [5] Gender Differences and Temporal Trends in Clinical Characteristics and Use of Myocardial Scintigraphy in Evaluation of Stable CAD
    Lakshmanan, Suvasini
    Frumento, Paolo
    Giorgetti, Assuero
    Dalmiani, Stefano
    Gimelli, Alessia
    CIRCULATION, 2022, 146
  • [6] Gender differences in the clinical features and outcomes of patients with coronary artery disease
    Wada, Hideki
    Miyauchi, Katsumi
    Daida, Hiroyuki
    EXPERT REVIEW OF CARDIOVASCULAR THERAPY, 2019, 17 (02) : 127 - 133
  • [7] Gender differences in quality of life in coronary artery disease patients with comorbidities undergoing coronary revascularization
    Oreel, Tom H.
    Nieuwkerk, Pythia T.
    Hartog, Iris D.
    Netjes, Justine E.
    Vonk, Alexander B. A.
    Lemkes, Jorrit
    van Laarhoven, Hanneke W. M.
    Scherer-Rath, Michael
    Sprangers, Mirjam A. G.
    Henriques, Jose P. S.
    PLOS ONE, 2020, 15 (06):
  • [8] Presenting Symptoms in Patients Undergoing Coronary Artery Disease Evaluation: Association With Noninvasive Test Results and Clinical Outcomes in the PROMISE Trial
    Lowenstern, Angela
    Alexander, Karen P.
    Pagidipati, Neha J.
    Hill, C. Larry
    Pellikka, Patricia A.
    Cooper, Lawton S.
    Alhanti, Brooke
    Hoffmann, Udo
    Mark, Daniel B.
    Douglas, Pamela S.
    CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2022, 15 (05): : 351 - 361
  • [9] GENDER DIFFERENCES IN CLINICAL-EVALUATION AND TRIAGE IN CORONARY-ARTERY DISEASE
    BERGELSON, BA
    TOMMASO, CL
    CHEST, 1995, 108 (06) : 1510 - 1513
  • [10] Gender differences in plaque characteristics of nonculprit lesions in patients with coronary artery disease
    Tian, Jiangtian
    Wang, Xuedong
    Tian, Jinwei
    Yu, Bo
    BMC CARDIOVASCULAR DISORDERS, 2019, 19 (1)