Variation in cardiovascular disease care: an Australian cohort study on sex differences in receipt of coronary procedures.

A new interesting article has been published in BMJ Open. 2019 Jul 23;9(7):e026507. doi: 10.1136/bmjopen-2018-026507. and titled:

Variation in cardiovascular disease care: an Australian cohort study on sex differences in receipt of coronary procedures.

Authors of this article are:

Fogg AJ, Welsh J, Banks E, Abhayaratna W, Korda RJ.

A summary of the article is shown below:

OBJECTIVES: The aim of this study was to quantify sex differences in diagnostic and revascularisation coronary procedures within 1 year of hospitalisation for acute myocardial infarction (AMI) or angina.DESIGN: This is a prospective cohort study. Baseline questionnaire (January 2006-April 2009) data from the Sax Institute’s 45 and Up Study were linked to hospitalisation and mortality data (to 30 June 2016) in a time-to-event analysis, treating death as a censoring event.SETTING: This was conducted in New South Wales, Australia.PARTICIPANTS: The study included participants aged ≥45 years with no history of ischaemic heart disease (IHD) who were admitted to hospital with a primary diagnosis of AMI (n=4580) or a primary diagnosis of angina or chronic IHD with secondary diagnosis of angina (n=4457).OUTCOME MEASURES: The outcome of this study was coronary angiography and coronary revascularisation with percutaneous coronary intervention or coronary artery bypass graft (PCI/CABG) within 1 year of index admission. Cox regression models compared coronary procedure rates in men and women, adjusting sequentially for age, sociodemographic variables and health characteristics.RESULTS: Among patients with AMI, 71.6% of men (crude rate 3.45/person-year) and 64.7% of women (2.62/person-year) received angiography; 57.8% of men (1.73/person-year) and 37.4% of women (0.77/person-year) received PCI/CABG. Adjusted HRs for men versus women were 1.00 (0.92-1.08) for angiography and 1.51 (1.38-1.67) for PCI/CABG. In the angina group, 67.3% of men (crude rate 2.36/person-year) and 54.9% of women (1.32/person-year) received angiography; 44.6% of men (0.90/person-year) and 19.5% of women (0.26/person-year) received PCI/CABG. Adjusted HRs were 1.24 (1.14-1.34) and 2.44 (2.16-2.75), respectively.CONCLUSIONS: Men are more likely than women to receive coronary procedures, particularly revascularisation. This difference is most evident among people with angina, where clinical guidelines are less prescriptive than for AMI.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Check out the article’s website on Pubmed for more information:

[link-preview url=https://www.ncbi.nlm.nih.gov/pubmed/31337660 forceshot=true]

This article is a good source of information and a good way to become familiar with topics such as: 45 and Up study;cardiovascular disease;coronary procedure;health inequality;linked data.

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