Clinical Research in Cardiology

, Volume 104, Issue 6, pp 507–517

Gender differences in therapeutic recommendation after diagnostic coronary angiography: insights from the Coronary Angiography and PCI Registry of the German Society of Cardiology

  • Tobias Heer
  • Matthias Hochadel
  • Karin Schmidt
  • Julinda Mehilli
  • Ralf Zahn
  • Karl-Heinz Kuck
  • Christian Hamm
  • Michael Böhm
  • Georg Ertl
  • Dietrich Andresen
  • Steffen Massberg
  • Jochen Senges
  • Günter Pilz
  • Anselm K. Gitt
  • Uwe Zeymer
Original Paper

DOI: 10.1007/s00392-015-0815-6

Cite this article as:
Heer, T., Hochadel, M., Schmidt, K. et al. Clin Res Cardiol (2015) 104: 507. doi:10.1007/s00392-015-0815-6
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Abstract

Background

There is information suggesting differences and underuse of invasive coronary diagnostic and therapeutic procedures in women compared to men.

Methods

Data from consecutive patients (pts) which were enrolled in the Coronary Angiography and PCI Registry of the German Society of Cardiology were analyzed. We compared gender-related differences in diagnosis and therapeutic recommendation of pts undergoing coronary angiography (XA) for stable coronary artery disease (CAD), non-ST elevation acute coronary syndromes (NSTE-ACS) and ST elevation myocardial infarction (STEMI).

Results

From 2004 until the end of 2009, data of 1,060,542 invasive procedures in 1,014,996 pts were prospectively registered. One-third (34.6 %) of them were female. Women less often had significant CAD, irrespective of the indication for XA. In pts with relevant CAD, percutaneous coronary interventions (PCI) were recommended in 87.1 % of women versus 89.1 % of men with STEMI [age-adjusted OR (aOR) 0.98, 95 % CI 0.93–1.04], in 67.1 vs. 66.8 % in NSTE-ACS (aOR 1.10, 1.07–1.12), and in 50.3 vs 49.4 % in stable CAD (aOR 1.07, 1.05–1.09).

Conclusions

In pts with significant CAD, there was no difference in recommendation for PCI between the genders in stable CAD, whereas in STEMI and NSTE-ACS women were treated even more often with PCI. There were only minor differences in referral for CABG between women and men. Hence, our data provide strong evidence against a gender bias in use of invasive therapeutic procedures once the diagnosis of significant CAD has been confirmed.

Keywords

Gender differences Women Coronary angiography Coronary artery disease 

Abbreviations

CABG

Coronary artery bypass graft

CAD

Coronary artery disease

CI

Confidence interval

NSTE-ACS

Non-ST elevation acute coronary syndrome

PCI

Percutaneous coronary intervention

STEMI

ST elevation myocardial infarction

XA

Coronary angiography

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Tobias Heer
    • 1
  • Matthias Hochadel
    • 2
  • Karin Schmidt
    • 3
  • Julinda Mehilli
    • 4
  • Ralf Zahn
    • 3
  • Karl-Heinz Kuck
    • 5
  • Christian Hamm
    • 6
  • Michael Böhm
    • 7
  • Georg Ertl
    • 8
  • Dietrich Andresen
    • 9
  • Steffen Massberg
    • 4
  • Jochen Senges
    • 2
  • Günter Pilz
    • 1
  • Anselm K. Gitt
    • 2
    • 3
  • Uwe Zeymer
    • 2
    • 3
  1. 1.Department of Cardiology, Krankenhaus Agatharied, Academic Teaching HospitalUniversity of MunichHaushamGermany
  2. 2.Stiftung Institut für Herzinfarktforschung LudwigshafenLudwigshafenGermany
  3. 3.Medizinische Klinik BKlinikum der Stadt LudwigshafenLudwigshafenGermany
  4. 4.Medizinische Klinik IKlinikum der Ludwig-Maximilians-Universität MünchenMunichGermany
  5. 5.Asklepios Klinik St. Georg HamburgHamburgGermany
  6. 6.Kerckhoff Klinik Bad NauheimBad NauheimGermany
  7. 7.Universitätsklinikum des SaarlandesHomburg/SaarGermany
  8. 8.Medizinische Klinik und Poliklinik I, Comprehensive Heart Failure CenterUniversitätsklinikum WürzburgWürzburgGermany
  9. 9.Vivantes Klinikum Am UrbanBerlinGermany