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Titolo:
Gender differences and temporal trends in clinical characteristics, stresstest results and use of invasive procedures in patients undergoing evaluation for coronary artery disease
Autore:
Miller, TD; Roger, VL; Hodge, DO; Hopfenspirger, MR; Bailey, KR; Gibbons, RJ;
Indirizzi:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA Mayo Clin Rochester MN USA 55905 Cardiovasc Dis, Rochester, MN 55905 USA Mayo Clin, Div Biostat, Rochester, MN 55905 USA Mayo Clin Rochester MN USA 55905 in, Div Biostat, Rochester, MN 55905 USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 3, volume: 38, anno: 2001,
pagine: 690 - 697
SICI:
0735-1097(200109)38:3<690:GDATTI>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; SEX-DIFFERENCES; REVASCULARIZATION PROCEDURES; CARDIAC PROCEDURES; UNSTABLE ANGINA; BYPASS SURGERY; HEART-DISEASE; WOMEN; BIAS; MANAGEMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
49
Recensione:
Indirizzi per estratti:
Indirizzo: Miller, TD Mayo Clin, Div Cardiovasc Dis, East 16-B,200 1st St SW, Rochester, MN 55905 USA Mayo Clin East 16-B,200 1st St SW Rochester MN USA 55905 05 USA
Citazione:
T.D. Miller et al., "Gender differences and temporal trends in clinical characteristics, stresstest results and use of invasive procedures in patients undergoing evaluation for coronary artery disease", J AM COL C, 38(3), 2001, pp. 690-697

Abstract

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 angiographyand revascularization. BACKGROUND Gender bias may influence resource utilization in patients withcoronary 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 undergocoronary angiography (p < 0.001). Male gender was independently associatedwith 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 Collegeof Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 11:46:15