Key result
Rural settings linked to ~58% lower angiography referral after positive stress tests versus urban centers.
Why the study?
Does geographic location (rural vs urban) affect the therapeutic consequences of exercise testing and referral for coronary angiography in patients suspected of having angina pectoris?
Observational (n=2,934)
Yes
Does geographic location (rural vs urban) affect the therapeutic consequences of exercise testing and referral for coronary angiography in patients suspected of having angina pectoris?
Answers are grounded in this paper and cite their sources.
This study investigates regional differences (rural vs urban) in the referral for coronary angiography following exercise stress testing in Denmark.
Coronary angiography is the main diagnostic test for deciding whether to refer a patient for coronary revascularisation, but referral for coronary angiography may vary significantly among regions. 1 2 Regional differences have been explained by the fact that access to cardiac catheterisation facilities is associated with a higher likelihood of undergoing angiography. 3 4 We investigated the impact of exercise stress testing on decisions taken about patients suspected of having angina pectoris and the barriers to referral for coronary angiography.
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Troels Niemann (2001) conducted an observational in Suspected angina pectoris (n=2,934). Urban hospital location (closer to angiography center) vs. Rural hospital location (farther from angiography center) was evaluated on Referral for coronary angiography following an exercise test suggesting disease (RR 2.06 for women, RR 1.27 for men, 95% CI 1.39-3.05 (women), 1.09-1.50 (men), p=<0.01). Referral for coronary angiography in patients with an exercise test suggesting disease was significantly higher in urban versus rural settings, ranging from 79% at 21 km to 33% at 154 km from the center.
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