Female Disparity in Referral to Cardiac Diagnostication and Invasive Treatment

Area of Science:

• Cardiology
• Public Health
• Medical Research

Background:

• Ischemic heart disease (IHD) remains a leading global cause of death despite reductions in cardiovascular disease (CVD) mortality.
• Existing IHD clinical guidelines do not account for sex-based differences, and diagnostic disparities persist.
• Females experience higher mortality rates related to IHD.

Purpose of the Study:

• To analyze sex disparities in diagnostic procedures for IHD.
• To evaluate the outcomes of diagnostic procedures that do not lead to invasive treatments.
• To compare treatment rates and mortality between males and females undergoing cardiac diagnostics.

Main Methods:

• Analysis of 274,617 first-entry patients undergoing invasive coronary arteriography (ICA) or computed coronary arteriography (CTA) between 2000-2020.
• Data sourced from the Western Denmark Heart Registry.
• Mortality evaluated using Kaplan-Meier curves and compared to the general population.

Main Results:

• Females represented 34.1% of diagnostic procedures but only 25.5% of invasive treatments, indicating a lower treatment rate compared to males.
• All-cause 10-year mortality was higher in females post-treatment (1.26) but lower in non-treated patients (0.71) compared to males.
• Non-treated patients generally showed lower mortality than the background population, except for valve-related indications.

Conclusions:

• Females receive fewer invasive treatments than males, despite similar CVD prevalence referrals.
• Females exhibit significantly higher mortality after invasive treatments compared to males.
• Non-invasively treated females demonstrate superior survival rates compared to males and the background population.