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Gender differences in presentation, coronary intervention, and outcomes of 28,985 acute coronary syndrome patients in Victoria, Australia

Worrall-Carter, Linda, McEvedy, Samantha, Wilson, Andrew and Rahman, Muhammad Aziz 2016, Gender differences in presentation, coronary intervention, and outcomes of 28,985 acute coronary syndrome patients in Victoria, Australia, Womens health issues, vol. 26, no. 1, pp. 14-20, doi: 10.1016/j.whi.2015.09.002.

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Title Gender differences in presentation, coronary intervention, and outcomes of 28,985 acute coronary syndrome patients in Victoria, Australia
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 Womens health issues
Volume number 26
Issue number 1
Start page 14
End page 20
Total pages 7
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-01
ISSN 1049-3867
1878-4321
Keyword(s) Acute Coronary Syndrome
Acute Disease
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Angiography
Coronary Artery Bypass
Female
Hospital Mortality
Hospitalization
Humans
Logistic Models
Male
Middle Aged
Myocardial Infarction
Patient Readmission
Percutaneous Coronary Intervention
Retrospective Studies
Risk Factors
Sex Factors
Socioeconomic Factors
Survival Rate
Treatment Outcome
Victoria
Summary BACKGROUND: Differences in demographics, presenting characteristics, and treatment of heart disease in women may contribute to adverse outcomes. The purpose of this paper was to describe gender differences in the epidemiology, treatment, and outcomes of all admissions for acute coronary syndrome (ACS) in Victoria that occurred between June 2007 and July 2009. METHODS: We undertook a retrospective cohort study of all patients admitted to Victorian hospitals with a first time diagnosis of ACS. Use of angiograms, percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and adverse outcomes (death and/or unplanned readmission) were compared by gender and hierarchical logistic regression models were used to account for confounding variables. RESULTS: Of a total of 28,985 ACS patients, 10,455 (36%) were women. Compared with men, women were older (aged ≥75 years: 54% vs 31%; p < .001), more likely to present with multiple comorbidities (>1 comorbidity: 53% vs 46%; p < .001), and more likely to be diagnosed with non-ST-segment elevation ACS (86% vs 80%; p < .001). Women were less likely to receive coronary interventions (angiogram: adjusted odds ratio [aOR], 0.71; 95% CI, 0.66-0.75; PCI: aOR, 0.73; 95% CI, 0.66-0.80; CABG: aOR, 0.58; 95% CI, 0.53-0.64). Adverse outcomes were similar in women and men after accounting for confounding variables. CONCLUSIONS: Our results show that women in Victoria were less likely to receive coronary interventions after an admission for ACS. Clinicians should be wary of inherent gender bias in decisions to refer patients for angiography.
Language eng
DOI 10.1016/j.whi.2015.09.002
Field of Research 111799 Public Health and Health Services not elsewhere classified
1114 Paediatrics And Reproductive Medicine
1117 Public Health And Health Services
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Jacobs Institute of Women's Health
Persistent URL http://hdl.handle.net/10536/DRO/DU:30083582

Document type: Journal Article
Collection: School of Medicine
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