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Gender differences in clinical evaluation and triage in coronary artery disease
1Department of Medicine, Northwestern Memorial Hospital, Northwestern University Medical School, Chicago.
Background:
Women undergo evaluation and treatment for cardiac diseases less frequently than men with similar symptoms. The purpose of this study was to determine what differences exist in clinical evaluation and treatment between men and women presenting with coronary heart disease that may indicate a gender bias.
Methods:
A single hospital retrospective review of patients admitted with the diagnosis of cardiac ischemic syndrome, undergoing stress testing, coronary arteriography, percutaneous interventional procedure, or coronary bypass surgery was performed, including an evaluation by gender of the demographic, clinical, and angiographic parameters of 1 year of patients undergoing hospital admission, evaluation, or revascularization therapy for coronary heart disease in a single university hospital.
Results:
Women admitted to the coronary care unit with a coronary diagnosis were less likely to undergo coronary arteriography than men. Women having a positive stress test result were as likely to undergo coronary arteriography as men with similar findings. Women undergoing coronary arteriography were as likely as men to undergo percutaneous transluminal coronary angioplasty, but less likely to undergo coronary artery bypass surgery.
Conclusions:
A gender-based selection bias exists in choosing patients to undergo coronary arteriography and coronary artery bypass grafting.