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Related Experiment Videos

Sex differences in evaluation and outcome after stress testing.

Véronique L Roger1, Steven J Jacobsen, Susan A Weston

  • 1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.

Mayo Clinic Proceedings
|July 11, 2002
PubMed
Summary

Men with positive stress tests were more likely to receive angiography, but this difference disappeared when accounting for their higher coronary artery disease (CAD) probability. Men without established CAD faced worse outcomes, including higher risks of death and cardiac events.

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Area of Science:

  • Cardiology
  • Public Health
  • Sex Differences in Medicine

Background:

  • Coronary artery disease (CAD) diagnosis and management can differ between sexes.
  • Understanding sex-based variations in stress testing evaluation and outcomes is crucial for equitable cardiovascular care.

Purpose of the Study:

  • To investigate sex-based differences in the evaluation and outcomes following stress testing for coronary artery disease (CAD).
  • To analyze referral patterns for coronary angiography and long-term clinical events stratified by sex and CAD probability.

Main Methods:

  • A population-based cohort study in Olmsted County, Minnesota, included 2276 men and 1270 women undergoing stress tests between 1987-1990.
  • End points included coronary angiography referral, all-cause mortality, and major cardiac events.

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  • Statistical analyses adjusted for age, risk factors, comorbidities, and predicted CAD probability.

    • Main Results:

    • Women were older with more comorbidities. Among those without documented CAD, men had a higher median predicted CAD probability.
    • Men with positive stress tests were more likely to undergo angiography, but this was not significant after adjusting for CAD probability.
    • Without established CAD, men showed a higher adjusted risk of death (RR 1.40) and cardiac events (RR 1.67) compared to women.

    Conclusions:

    • Sex differences in angiography use after positive stress tests were explained by higher CAD probability in men.
    • In the absence of documented CAD, men experienced worse long-term outcomes, highlighting a sex disparity in risk.
    • No significant sex differences in angiography use or outcomes were observed among patients with established CAD.