Gender differences in the patterns of coronary angiography and PTCA use in a university hospital in Taiwan
1Department of Internal Medicine (Cardiology), National Taiwan University College of Medicine, Taipei, Taiwan.
Insights
Men underwent more coronary angiography (CAG) and angioplasty (PTCA) than women in Taiwan. The impact of CAG on PTCA was also greater in men, highlighting gender disparities in cardiovascular procedure utilization.
Area of Science:
- Cardiovascular Medicine
- Medical Interventions
- Health Services Research
Background:
- Coronary artery disease (CAD) necessitates diagnostic and interventional procedures.
- Long-term trends in coronary angiography (CAG) and percutaneous transluminal coronary angioplasty (PTCA) use, particularly concerning gender in Asian populations, remain underexplored.
- Understanding these trends is crucial for equitable healthcare delivery.
Purpose of the Study:
- To investigate gender-based differences in the utilization patterns of CAG and PTCA.
- To analyze temporal trends in these procedures within a Taiwanese university hospital setting.
- To examine the relationship between CAG and PTCA frequency across genders.
Main Methods:
- A retrospective analysis of monthly CAG and PTCA data from 1983 to 1996 in a Taipei university hospital.
- Time series analysis, including integrated moving average and transfer function modeling, was employed.
- Intervention analysis was used to assess the impact of specific events, like the addition of a catheterization room.
Main Results:
- Both CAG and PTCA frequencies significantly increased from 1983 to 1996, with a notable rise in PTCA post-1990.
- Men underwent CAG and PTCA procedures at a higher rate than women.
- Time series models indicated men had 2.5 times greater CAG intercepts and 4.4 times greater PTCA intercepts than women. The influence of CAG on PTCA was 1.8 times greater in men. The impact of a new catheterization room was 2.8 times greater in men.
Conclusions:
- Women received fewer CAG and PTCA procedures compared to men.
- The effect of CAG on PTCA utilization was significantly more pronounced in men than in women.
- Findings underscore gender disparities in access to and utilization of advanced cardiovascular interventions in Taiwan during the study period.
Background And Purpose:
Coronary artery angiography (CAG) and percutaneous transluminal coronary angioplasty (PTCA) are important procedures for the diagnosis and treatment of patients with coronary artery disease. However, long-term trends in the frequency of CAG and PTCA use and their relation to gender have not been clearly determined in the Asian population. The purpose of this study was to investigate gender differences in the patterns of CAG and PTCA use in a university hospital in Taiwan during the period of 1983 through 1996.
Methods:
We studied the monthly data of all patients who underwent CAG or PTCA in a university hospital in Taipei from 1983 through 1996. A time series analysis was used to estimate gender differences in the patterns of CAG and PTCA use.
Results:
The frequency of CAG and PTCA increased significantly during this period. Before 1990, only a small number of patients underwent PTCA. However, this number increased steadily after 1990. Men were more likely to undergo CAG and PTCA than women. A time series analysis with fitted models was used to create an integrated moving average model. For CAG, the value of the estimated intercept for men was 2.5 times greater than that for women. In the PTCA series, the value of the intercept in men was 4.4 times greater than that in women. The patterns of trend change showed greater increases in men than in women, and a greater increase in the PTCA than in the CAG series. By transfer function modeling and intervention analysis, we found that the effect of CAG on the frequency of PTCA in men was 1.8 times greater than its effect in women. The estimated influence of the use of a new catheterization room (added in 1993) was 2.8 times greater in men than in women. The fitted model correlated well with the observed values in the next 12 months for both genders.
Conclusions:
We concluded that women had fewer CAG and PTCA procedures than men, and the influence of CAG on the PTCA series was significantly higher in men than in women.
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