Women with non-ST-elevation ACS underwent in-hospital coronary angiography significantly less often than men (adjusted OR 0.71; 95% CI 0.55-0.93; p=0.01), including among high-risk patients.
Observational (n=1,399)
Yes
Does female sex affect the management and outcomes of patients with non-ST-elevation acute coronary syndrome compared to male sex?
Women presenting with non-ST-elevation ACS are less likely to receive aspirin and early invasive angiography compared to men, highlighting a gender disparity in guideline-directed care.
Effect estimate: adjusted OR 0.71 (95% CI 0.55 to 0.93)
p-value: p=0.01
OBJECTIVES: To compare management and outcome of female and male non-ST-elevation acute coronary syndrome (ACS) patients. DESIGN: FINACS Studies are prospective registries of non-ST-elevation ACS patients conducted in 2001, 2003, and 2005 in nine hospitals. RESULTS: The studies enrolled 1,399 patients from which 39% were women. During hospitalisation women were treated less often than men with aspirin (odds ratio OR) for women 0.60, 95% confidence interval CI 0.41 to 0.88, p=0.03). Women underwent less often in-hospital coronary angiography than men (adjusted OR 0.71, 95% CI 0.55 to 0.93, p=0.01). Also in the subgroup of younger (<75 years) high-risk patients, female sex was independent predictor for not performing in-hospital angiography (OR 0.64, 95% CI 0.42 to 0.97, p=0.04). Age-adjusted mortality at 6 months was similar between men and women. CONCLUSIONS: Compared to men women received less often aspirin. Women were referred less often to in-hospital coronary angiography. Under-use of in-hospital angiography was evident also in patients with high-risk features when guidelines recommend early invasive treatment.
Vikman et al. (Mon,) conducted a observational in non-ST-elevation acute coronary syndrome (ACS) (n=1,399). Female sex vs. Male sex was evaluated on In-hospital coronary angiography (adjusted OR 0.71, 95% CI 0.55 to 0.93, p=0.01). Women with non-ST-elevation ACS underwent in-hospital coronary angiography significantly less often than men (adjusted OR 0.71; 95% CI 0.55-0.93; p=0.01), including among high-risk patients.