Comparison of Baseline Characteristics, Management and Outcome of Patients With Non–ST-Segment Elevation Acute Coronary Syndrome in Versus Not in Clinical Trials

Hutchinson-Jaffe, Adam; Goodman, Shaun G.; Yan, Raymond T.; Wald, Ron; Elbarouni, Basem; Rose, Barry; Eagle, Kim A.; Lai, Christopher C.; Baer, Carolyn; Langer, Anatoly

doi:10.1016/j.amjcard.2010.06.070

Cited by 36 publications

(28 citation statements)

References 30 publications

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“…However, the reported evidence is only partially satisfactory because of systematic exclusion of more complex patients from randomised clinical trials,26 where older participants are less, and definitively healthier, than in clinical practice 27. Nevertheless, well-conducted observational studies help fill the gap between randomised trials and clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes

Bari

Balzi²,

Fracchia

et al. 2014

Heart

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Section: Discussionmentioning

confidence: 99%

Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes

Bari

Balzi²,

Fracchia

et al. 2014

Heart

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“…In such situations, the decision whether to refer for coronary angiography and revascularization is made on a case‐by‐case basis and in consultation with the patient and their representatives . Serious comorbidities which might preclude the use of angiography have been difficult to define and the situation is further complicated by a lack of representation of patients with multiple comorbidities in clinical trials . Consequently, physicians' clinical experience and patients' views on treatment choice are often relied on more than guideline recommendations when making decisions in these complex circumstances .…”

Section: Introductionmentioning

confidence: 99%

Impact of comorbidities and gender on the use of coronary interventions in patients with high‐risk non‐ST‐segment elevation acute coronary syndrome

Worrall‐Carter

McEvedy

Wilson

et al. 2015

Cathet Cardio Intervent

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“…In such situations, the decision whether to refer for coronary angiography and revascularization is made on a case-by-case basis and in consultation with the patient and their representatives [3]. Serious comorbidities which might preclude the use of angiography have been difficult to define and the situation is further complicated by a lack of representation of patients with multiple comorbidities in clinical trials [5,6]. Consequently, physicians' clinical experience and patients' views on treatment choice are often relied on more than guideline recommendations when making decisions in these complex circumstances [7].…”

Section: Introductionmentioning

confidence: 99%

Impact of comorbidities and gender on the use of coronary interventions in patients with high-risk non-ST-segment elevation acute coronary syndrome

Worrall‐Carter

McEvedy

Wilson

et al. 2015

Heart, Lung and Circulation

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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. V C 2015 Wiley Periodicals, Inc.

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Comparison of Baseline Characteristics, Management and Outcome of Patients With Non–ST-Segment Elevation Acute Coronary Syndrome in Versus Not in Clinical Trials

Cited by 36 publications

References 30 publications

Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes

Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes

Impact of comorbidities and gender on the use of coronary interventions in patients with high‐risk non‐ST‐segment elevation acute coronary syndrome

Impact of comorbidities and gender on the use of coronary interventions in patients with high-risk non-ST-segment elevation acute coronary syndrome

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