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Gender differences in the management and clinical outcome of stable angina.
Circulation. 2006 Jan 31; 113(4):490-8.Circ

Abstract

BACKGROUND

We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year.

METHODS AND RESULTS

The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable angina on initial assessment by a cardiologist. Baseline clinical details and cardiac investigations planned or performed within a 4-week period of the assessment were recorded, and follow-up data were collected at 1 year. A total of 3779 patients were included in the survey; 42% were female. Women were less likely to undergo an exercise ECG (odds ratio, 0.81; 95% CI, 0.69 to 0.95) and less likely to be referred for coronary angiography (odds ratio, 0.59; 95% CI, 0.48 to 0.72). Antiplatelet and statin therapies were used significantly less in women than in men, both at initial assessment and at 1 year, even in those in whom coronary disease had been confirmed. Women with confirmed coronary disease were less likely to be revascularized than their male counterparts and were twice as likely to suffer death or nonfatal myocardial infarction during the 1-year follow-up period (hazard ratio, 2.09; 95% CI, 1.13 to 3.85), even after multivariable adjustment for age, abnormal ventricular function, severity of coronary disease, and diabetes.

CONCLUSIONS

Significant gender bias has been identified in the use of investigations and evidence-based medical therapy in stable angina. Women were also less likely to be revascularized. The observed bias is of particular concern in light of the adverse prognosis observed among women with stable angina and confirmed coronary disease.

Authors+Show Affiliations

Royal Brompton Hospital, Sydney St, London SW3 6 NP, UK. caroline.daly@imperial.ac.uk.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

16449728

Citation

Daly, Caroline, et al. "Gender Differences in the Management and Clinical Outcome of Stable Angina." Circulation, vol. 113, no. 4, 2006, pp. 490-8.
Daly C, Clemens F, Lopez Sendon JL, et al. Gender differences in the management and clinical outcome of stable angina. Circulation. 2006;113(4):490-8.
Daly, C., Clemens, F., Lopez Sendon, J. L., Tavazzi, L., Boersma, E., Danchin, N., Delahaye, F., Gitt, A., Julian, D., Mulcahy, D., Ruzyllo, W., Thygesen, K., Verheugt, F., & Fox, K. M. (2006). Gender differences in the management and clinical outcome of stable angina. Circulation, 113(4), 490-8.
Daly C, et al. Gender Differences in the Management and Clinical Outcome of Stable Angina. Circulation. 2006 Jan 31;113(4):490-8. PubMed PMID: 16449728.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gender differences in the management and clinical outcome of stable angina. AU - Daly,Caroline, AU - Clemens,Felicity, AU - Lopez Sendon,Jose L, AU - Tavazzi,Luigi, AU - Boersma,Eric, AU - Danchin,Nicholas, AU - Delahaye,Francois, AU - Gitt,Anselm, AU - Julian,Desmond, AU - Mulcahy,David, AU - Ruzyllo,Witold, AU - Thygesen,Kristian, AU - Verheugt,Freek, AU - Fox,Kim M, AU - ,, PY - 2006/2/2/pubmed PY - 2006/2/28/medline PY - 2006/2/2/entrez SP - 490 EP - 8 JF - Circulation JO - Circulation VL - 113 IS - 4 N2 - BACKGROUND: We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. METHODS AND RESULTS: The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable angina on initial assessment by a cardiologist. Baseline clinical details and cardiac investigations planned or performed within a 4-week period of the assessment were recorded, and follow-up data were collected at 1 year. A total of 3779 patients were included in the survey; 42% were female. Women were less likely to undergo an exercise ECG (odds ratio, 0.81; 95% CI, 0.69 to 0.95) and less likely to be referred for coronary angiography (odds ratio, 0.59; 95% CI, 0.48 to 0.72). Antiplatelet and statin therapies were used significantly less in women than in men, both at initial assessment and at 1 year, even in those in whom coronary disease had been confirmed. Women with confirmed coronary disease were less likely to be revascularized than their male counterparts and were twice as likely to suffer death or nonfatal myocardial infarction during the 1-year follow-up period (hazard ratio, 2.09; 95% CI, 1.13 to 3.85), even after multivariable adjustment for age, abnormal ventricular function, severity of coronary disease, and diabetes. CONCLUSIONS: Significant gender bias has been identified in the use of investigations and evidence-based medical therapy in stable angina. Women were also less likely to be revascularized. The observed bias is of particular concern in light of the adverse prognosis observed among women with stable angina and confirmed coronary disease. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/16449728/Gender_differences_in_the_management_and_clinical_outcome_of_stable_angina_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.105.561647?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -