TY - JOUR T1 - Gender disparities in the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: large-scale observations from the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines) National Quality Improvement Initiative. AU - Blomkalns,Andra L, AU - Chen,Anita Y, AU - Hochman,Judith S, AU - Peterson,Eric D, AU - Trynosky,Kelly, AU - Diercks,Deborah B, AU - Brogan,Gerard X,Jr AU - Boden,William E, AU - Roe,Matthew T, AU - Ohman,E Magnus, AU - Gibler,W Brian, AU - Newby,L Kristin, AU - ,, PY - 2004/07/20/received PY - 2004/11/22/revised PY - 2004/11/29/accepted PY - 2005/3/16/pubmed PY - 2005/6/29/medline PY - 2005/3/16/entrez SP - 832 EP - 7 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 45 IS - 6 N2 - OBJECTIVES: We hypothesized that significant disparities in gender exist in the management of patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS). BACKGROUND: Gender-related differences in the diagnosis and treatment of ACS have important healthcare implications. No large-scale examination of these disparities has been completed since the publication of the revised American College of Cardiology/American Heart Association guidelines for management of patients with NSTE ACS. METHODS: Using data from the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines) National Quality Improvement Initiative, we examined differences of gender in treatment and outcomes among patients with NSTE ACS. RESULTS: Women (41% of 35,875 patients) were older (median age 73 vs. 65 years) and more often had diabetes and hypertension. Women were less likely to receive acute heparin, angiotensin-converting enzyme inhibitors, and glycoprotein IIb/IIIa inhibitors and less commonly received aspirin, angiotensin-converting enzyme inhibitors, and statins at discharge. The use of cardiac catheterization and revascularization was higher in men, but among patients with significant coronary disease, percutaneous revascularization was performed in a similar proportion of women and men. Women were at higher risk for unadjusted in-hospital death (5.6% vs. 4.3%), reinfarction (4.0% vs. 3.5%), heart failure (12.1% vs. 8.8%), stroke (1.1% vs. 0.8%), and red blood cell transfusion (17.2% vs. 13.2%), but after adjustment, only transfusion was higher in women. CONCLUSIONS: Despite presenting with higher risk characteristics and having higher in-hospital risk, women with NSTE ACS are treated less aggressively than men. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/15766815/Gender_disparities_in_the_diagnosis_and_treatment_of_non_ST_segment_elevation_acute_coronary_syndromes:_large_scale_observations_from_the_CRUSADE__Can_Rapid_Risk_Stratification_of_Unstable_Angina_Patients_Suppress_Adverse_Outcomes_With_Early_Implementation_of_the_American_College_of_Cardiology/American_Heart_Association_Guidelines__National_Quality_Improvement_Initiative_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(04)02506-9 DB - PRIME DP - Unbound Medicine ER -