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Title: Impact of comordities and gender on the use of coronary interventions in patients with high-risk non-ST-segment elevation acute coronary syndrome.
Authors: Wilson, Andrew
Other Authors: Worrall-Carter, Linda
McEvedy, Samantha
Rahman, Muhammad
Keywords: Cardiac Sciences Clinical Institute, Epworth HealthCare, Victoria, Australia
Coronary Disease
Coronary Heart Disease
Acute Coronary Syndrome
Percutaneous Coronary Intervention
Coronary Angiography
Angiography, Coronary
Correspondence Analysis
Issue Date: Aug-2015
Publisher: Wiley Online Library
Citation: Catheterization and Cardiovascular Interventions 2015 Aug 17
Abstract: OBJECTIVES: To determine the impact of gender and comorbidity on use of coronary interventions in patients diagnosed with high-risk non-ST-segment acute coronary syndrome (NSTEACS). BACKGROUND: Guidelines recommend the use of coronary angiography for all patients diagnosed with NSTEACS with high-risk features, except in the presence of severe comorbidities. However, little is understood about the relationship between gender, comorbidity, and the use of coronary interventions. METHODS: Retrospective analyses of the Victorian Admitted Episodes Data Set (VAED) including all patients diagnosed with NSTEACS with high-risk features on their first admission for ACS between June 2007 and July 2009. Hierarchical logistic regression models and correspondence analyses were used to understand the relationship between gender, comorbidities, and the use of coronary interventions. RESULTS: Out of 16,771 NSTEACS patients with high-risk features, 6,338 (38%) were female. Females were older than males (aged ≥75: 62% vs 39%, p < 0.001) and more likely to have multiple comorbidities (≥2: 66% vs 59%, p < 0.001). After adjusting for potential confounders, females were more likely to receive no coronary intervention than males with a similar number of comorbid conditions (no comorbidities: OR 1.62, 95% CI 1.28-2.05; 1 comorbidity: OR 1.67, 95% CI 1.44-1.93; 2 comorbidities: OR 1.93, 95% CI 1.66-2.23; ≥3 comorbidities: OR 1.42, 95% CI 1.27-1.60). CONCLUSIONS: Lower rates of coronary intervention in females persisted after adjusting for number of comorbidities which suggests that gender may bias decisions regarding referral for coronary intervention in high-risk NSTEACS independent of other factors. © 2015 Wiley Periodicals, Inc.
Description: Epub ahead of print.
DOI: 10.1002/ccd.26117
PubMed URL:
ISSN: 1522-726X
Journal Title: Catheterization and Cardiovascular Interventions
Type: Journal Article
Affiliated Organisations: St Vincent's Centre for Nursing Research (SVCNR), Australian Catholic University, Melbourne, Victoria, Australia
St Vincent's Hospital, Melbourne, Victoria, Australia
The Cardiovascular Research Centre (CvRC), Australian Catholic University, Melbourne, Victoria, Australia
The University of Melbourne, Melbourne, Victoria, Australia
Department of Health, VicHealth, Victorian Cardiology Clinical Network, Melbourne, Victoria, Australia
Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Cardiac Sciences

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