Impact of comorbidities and gender on the use of coronary interventions in patients with high-risk non-ST-segment elevation acute coronary syndrome

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, vol. 87, no. 4, pp. E128-E136, doi: 10.1002/ccd.26117.

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Title Impact of comorbidities and gender on the use of coronary interventions in patients with high-risk non-ST-segment elevation acute coronary syndrome
Author(s) Worrall-Carter, Linda
McEvedy, Samantha
Wilson, Andrew
Rahman, Muhammad AzizORCID iD for Rahman, Muhammad Aziz orcid.org/0000-0003-1665-7966
Journal name Catheterization and cardiovascular interventions
Volume number 87
Issue number 4
Start page E128
End page E136
Total pages 9
Publisher Wiley-Blackwell
Place of publication Chichester, Eng.
Publication date 2016-03
ISSN 1522-726X
Keyword(s) coronary heart disease
women
angiogram
percutaneous coronary intervention
correspondence analysis
Summary 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.
Language eng
DOI 10.1002/ccd.26117
Field of Research 110201 Cardiology (incl Cardiovascular Diseases)
1102 Cardiovascular Medicine And Haematology
Socio Economic Objective 920103 Cardiovascular System and Diseases
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Wiley Periodicals
Persistent URL http://hdl.handle.net/10536/DRO/DU:30083581

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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