Gender Disparities in Cardiac Catheterization Rates Among Emergency Department Patients With Chest Pain.

Area of Science:

• Cardiology
• Health Services Research
• Gender Studies in Medicine

Background:

• Previous research indicates gender-based differences in cardiac testing rates.
• This study focuses on disparities in cardiac catheterization for chest pain patients without prior myocardial infarction (MI) or recent positive stress tests.

Purpose of the Study:

• To evaluate gender differences in cardiac catheterization and stenting rates among emergency department patients presenting with chest pain.
• To specifically analyze these differences in patients without a history of MI or a positive stress test.

Main Methods:

• Prospective evaluation of 2242 chest pain patients at an urban academic medical center.
• Data collection included baseline information, cardiac stress testing, cardiac catheterization, and stenting.
• Primary outcome: gender disparities in cardiac catheterization and stenting for patients without MI or positive stress test.

Main Results:

• Men and women showed similar rates of cardiac stress testing (16.7% vs. 15.2%) and positive stress tests (2.9% vs. 1.9%).
• Men were significantly more likely to undergo cardiac catheterization (10.4% vs. 4.9%, P < 0.001).
• Among patients without MI or positive stress test, men had higher rates of cardiac catheterization (5.8% vs. 3.3%, P = 0.010) and stent placement (2.1% vs. 0.7%, P = 0.003).

Conclusions:

• Gender disparities in cardiac testing persist, with men receiving more aggressive treatment.
• Men without MI or positive stress tests were more likely to undergo cardiac catheterization and stenting.
• This suggests a potential bias towards more invasive cardiac procedures for men in this patient group.