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Impact of gender on use of revascularization in acute coronary syndromes: the national observational study of diagnostic and interventional cardiac catheterization (ONACI).
Catheter Cardiovasc Interv 2015; 86(2):E58-65CC

Abstract

OBJECTIVES

To assess the impact of gender on myocardial revascularization using data collected in a French nationwide registry: the national observational study of diagnostic and interventional cardiac catheterization (ONACI).

BACKGROUND

Gender differences in management of patients with acute coronary syndromes (ACS) have been reported.

METHODS

We analysed data from a nationwide French prospective multicentre registry including 64,932 suspected ACS patients recruited in 99 centres from 2004 to 2008.

RESULTS

Overall, women were older (70.7 ± 12.7 vs. 63.8 ± 12.9 years), had a higher cardiovascular risk profile, and were more frequently admitted with non ST-elevation myocardial infarction or unstable angina (NSTEMI/UA) compared to men (73% vs. 68%). Women had significantly more angiographically normal coronary arteries or non-significant coronary artery disease (CAD) in both STEMI (6% vs. 3%) and NSTEMI/UA (21% vs. 11%) while men had more severe CAD. After adjusting for age, cardiovascular risk factors, and extent of disease, myocardial revascularization (defined as the use of percutaneous coronary intervention (PCI) or coronary artery bypass grafting) was less frequently used in women (adjusted OR = 0.78; 95% CI: 0.77-0.83). For those receiving PCI, in-hospital mortality within 24 hr of intervention was higher in women (3.6% vs. 1.2%; adjusted OR = 1.51; 95% CI: 1.22-1.87).

CONCLUSIONS

In the present study, despite having a higher cardiovascular risk profile, women more frequently had normal vessel/non-significant angiographic coronary artery disease. In patients with significant coronary artery disease, myocardial revascularization was less frequently used in women whatever the type of ACS.

Authors+Show Affiliations

Department of Cardiology, Hôpital Européen Georges Pompidou, Assistance Publique Des Hôpitaux De Paris, France; Université Paris Descartes, Paris, France.Department of Cardiology, Hôpital Européen Georges Pompidou, Assistance Publique Des Hôpitaux De Paris, France; Université Paris Descartes, Paris, France.Department of Cardiology, Hôpital Européen Georges Pompidou, Assistance Publique Des Hôpitaux De Paris, France; Université Paris Descartes, Paris, France.Department of Cardiology, University Hospital of Rennes, Rennes, France.Paris Cardiovascular Research Center PARCC, INSERM U970, Paris, France.Department of Cardiology, University Hospital of Brest, Brest, France.Department of Cardiology, Institut Hospitalier Jacques Cartier, Massy, France.Société Française De Cardiologie, Paris, France.Department of Cardiology, Hôpital Européen Georges Pompidou, Assistance Publique Des Hôpitaux De Paris, France; Université Paris Descartes, Paris, France.Department of Cardiology, Hôpital Européen Georges Pompidou, Assistance Publique Des Hôpitaux De Paris, France; Université Paris Descartes, Paris, France. Paris Cardiovascular Research Center PARCC, INSERM U970, Paris, France.Department of Cardiology, Hôpital Européen Georges Pompidou, Assistance Publique Des Hôpitaux De Paris, France; Université Paris Descartes, Paris, France. Paris Cardiovascular Research Center PARCC, INSERM U970, Paris, France.

Pub Type(s)

Comparative Study
Journal Article
Observational Study

Language

eng

PubMed ID

25810163

Citation

Isorni, Marc-Antoine, et al. "Impact of Gender On Use of Revascularization in Acute Coronary Syndromes: the National Observational Study of Diagnostic and Interventional Cardiac Catheterization (ONACI)." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 86, no. 2, 2015, pp. E58-65.
Isorni MA, Blanchard D, Teixeira N, et al. Impact of gender on use of revascularization in acute coronary syndromes: the national observational study of diagnostic and interventional cardiac catheterization (ONACI). Catheter Cardiovasc Interv. 2015;86(2):E58-65.
Isorni, M. A., Blanchard, D., Teixeira, N., le Breton, H., Renault, N., Gilard, M., ... Puymirat, E. (2015). Impact of gender on use of revascularization in acute coronary syndromes: the national observational study of diagnostic and interventional cardiac catheterization (ONACI). Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 86(2), pp. E58-65. doi:10.1002/ccd.25921.
Isorni MA, et al. Impact of Gender On Use of Revascularization in Acute Coronary Syndromes: the National Observational Study of Diagnostic and Interventional Cardiac Catheterization (ONACI). Catheter Cardiovasc Interv. 2015;86(2):E58-65. PubMed PMID: 25810163.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of gender on use of revascularization in acute coronary syndromes: the national observational study of diagnostic and interventional cardiac catheterization (ONACI). AU - Isorni,Marc-Antoine, AU - Blanchard,Didier, AU - Teixeira,Nelson, AU - le Breton,Hervé, AU - Renault,Nisa, AU - Gilard,Martine, AU - Lefèvre,Thierry, AU - Mulak,Geneviève, AU - Danchin,Nicolas, AU - Spaulding,Christian, AU - Puymirat,Etienne, Y1 - 2015/03/24/ PY - 2014/09/23/received PY - 2015/03/08/accepted PY - 2015/3/27/entrez PY - 2015/3/27/pubmed PY - 2016/4/26/medline KW - Keys words: acute coronary syndrome KW - gender KW - myocardial revascularization KW - percutaneous coronary intervention SP - E58 EP - 65 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 86 IS - 2 N2 - OBJECTIVES: To assess the impact of gender on myocardial revascularization using data collected in a French nationwide registry: the national observational study of diagnostic and interventional cardiac catheterization (ONACI). BACKGROUND: Gender differences in management of patients with acute coronary syndromes (ACS) have been reported. METHODS: We analysed data from a nationwide French prospective multicentre registry including 64,932 suspected ACS patients recruited in 99 centres from 2004 to 2008. RESULTS: Overall, women were older (70.7 ± 12.7 vs. 63.8 ± 12.9 years), had a higher cardiovascular risk profile, and were more frequently admitted with non ST-elevation myocardial infarction or unstable angina (NSTEMI/UA) compared to men (73% vs. 68%). Women had significantly more angiographically normal coronary arteries or non-significant coronary artery disease (CAD) in both STEMI (6% vs. 3%) and NSTEMI/UA (21% vs. 11%) while men had more severe CAD. After adjusting for age, cardiovascular risk factors, and extent of disease, myocardial revascularization (defined as the use of percutaneous coronary intervention (PCI) or coronary artery bypass grafting) was less frequently used in women (adjusted OR = 0.78; 95% CI: 0.77-0.83). For those receiving PCI, in-hospital mortality within 24 hr of intervention was higher in women (3.6% vs. 1.2%; adjusted OR = 1.51; 95% CI: 1.22-1.87). CONCLUSIONS: In the present study, despite having a higher cardiovascular risk profile, women more frequently had normal vessel/non-significant angiographic coronary artery disease. In patients with significant coronary artery disease, myocardial revascularization was less frequently used in women whatever the type of ACS. SN - 1522-726X UR - https://www.unboundmedicine.com/medline/citation/25810163/Impact_of_gender_on_use_of_revascularization_in_acute_coronary_syndromes:_the_national_observational_study_of_diagnostic_and_interventional_cardiac_catheterization__ONACI__ L2 - https://doi.org/10.1002/ccd.25921 DB - PRIME DP - Unbound Medicine ER -