Differences in admission rates and outcomes between men and women presenting to emergency departments with coronary syndromes

Kaul, Padma; Chang, Wei-Ching; Westerhout, Cynthia M.; Graham, Michelle M.; Armstrong, Paul W.

doi:10.1503/cmaj.060711

Cited by 66 publications

(41 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…15,354,363,364 Patient factors that may contribute to the increased prevalence of CS in women with MI include older age, higher rates of DM and hypertension, and higher incidence of underlying HF. 9,247,[365][366][367][368][369] Given the significant mortality benefit of early revascularization in the setting of AMI-associated CS, early revascularization (PCI or CABG) is recommended for all patients without contraindication who develop CS as a result of pump failure after AMI. 359,362,370 The use of an intra-aortic balloon pump is reasonable for hemodynamic support for women with CS that does not quickly stabilize with pharmacological therapy.…”

Section: Cardiogenic Shockmentioning

confidence: 99%

“…9,363,372 This may be related to higher rates of underlying hypertension, DM, and HF or may be due to longer delay in presentation to the hospital. 12,14,15,247,[365][366][367][368][369] Given the significant mortality benefit of early revascularization for patients with ACS, women with AMI-associated HF should undergo early angiography with subsequent risk stratification and revascularization when appropriate. 216,217,354 Medical stabilization with diuretics, vasodilators, inotropes, and percutaneous mechanical support should be provided when clinically indicated.…”

Section: Heart Failurementioning

confidence: 99%

See 1 more Smart Citation

Acute Myocardial Infarction in Women

Mehta¹,

Beckie²,

DeVon³

et al. 2016

Circulation

942

393

View full text Add to dashboard Cite

Cardiovascular disease is the leading cause of mortality in American women. Since 1984, the annual cardiovascular disease mortality rate has remained greater for women than men; however, over the last decade, there have been marked reductions in cardiovascular disease mortality in women. The dramatic decline in mortality rates for women is attributed partly to an increase in awareness, a greater focus on women and cardiovascular disease risk, and the increased application of evidence-based treatments for established coronary heart disease. This is the first scientific statement from the American Heart Association on acute myocardial infarction in women. Sex-specific differences exist in the presentation, pathophysiological mechanisms, and outcomes in patients with acute myocardial infarction. This statement provides a comprehensive review of the current evidence of the clinical presentation, pathophysiology, treatment, and outcomes of women with acute myocardial infarction.

show abstract

Section: Cardiogenic Shockmentioning

confidence: 99%

Section: Heart Failurementioning

confidence: 99%

Acute Myocardial Infarction in Women

Mehta¹,

Beckie²,

DeVon³

et al. 2016

Circulation

942

393

View full text Add to dashboard Cite

show abstract

“…Almost all newer studies show that gender differences are non-significant or marginal after controlling for age (Hanratty et al 2000;gottlieb et al 2000;Rathore et al 2002Rathore et al , 2003Khaykin et al 2002;Bertoni et al 2004;Pilote et al 2004;Bakler et al 2004;Williams et al 2004;moriel et al 2005;vaccarino et al 2005). In the two exceptions (fang and Alderman 2006; Kaul et al 2007), the outcome measure was "any revascularization," which includes both CABg and PCI, leaving the possibility that CABg rates had a gender difference while PCI rates did not. In some studies, PCI rates for females were higher than those for males (steingart et al 1991;Krumholz et al 1992;Rathore et al 2003;vaccarino et al 2005;Wong et al 1998;Kilaru et al 2000), although not all differences reached statistical significance.…”

Section: Comparisons With Other Studiesmentioning

confidence: 99%

Age Difference Explains Gender Difference in Cardiac Intervention Rates After Acute Myocardial Infarction

Fransoo

Martens²,

Prior³

et al. 2010

hcpol

View full text Add to dashboard Cite

many investigators have reported higher rates of cardiac procedures for males than females after acute myocardial infarction (AmI), suggesting that men are treated more aggressively than women. However, others have reported no significant differences after controlling for age, resulting in uncertainty about the existence of a true gender bias in cardiac care. In this study, a population-based cohort approach was used to calculate age-specific procedure rates by sex from administrative data. Chi-square tests and generalized linear modelling were used to assess gender differences and interactions. for all four procedures studied, rates were significantly higher for males than females (p<0.01). However, age-specific rates revealed few significant differences by gender and a sharp decrease in intervention rates with age for both males and females. generalized linear modelling confirmed that patient age was a significant predictor of intervention rates, whereas sex was not. The significant gender difference in overall rates was completely confounded by the older age profile of female AmI patients compared to their male counterparts. RésuméPlusieurs chercheurs ont observé de plus haut taux d'interventions cardiaques pour les hommes que pour les femmes après un infarctus aigu du myocarde (IAm), laissant

show abstract

“…3,54,55 For instance, women with coronary syndromes are less likely to be admitted to acute care and receive revascularization procedures compared with men and more likely to die after a critical illness in hospital. 56 There is a need to separate sex from gender in health research to understand and measure the impacts of gender relations, identity, and sex-linked biology. 53 Whereas sex refers to one's biological status, assigned at birth, gender is tied to a person's sense of self.…”

mentioning

confidence: 99%

Building a Foundation to Reduce Health Inequities: Routine Collection of Sociodemographic Data in Primary Care

Pinto

Glattstein-Young

Mohamed

et al. 2016

The Journal of the American Board of Family Medicine

114

View full text Add to dashboard Cite

Introduction: Detailed data on social determinants of health can facilitate the identification of inequities in access to health care. We report on a sociodemographic data collection tool used in a family medicine clinic.Methods: Four major health organizations in Toronto collaborated to identify a set of 14 questions that covered a range of social determinants of health. These were translated into 13 languages. This survey was self-administered using an electronic tablet to a convenience sample of 407 patients in the waiting room of a primary care clinic. Data were uploaded directly to the electronic medical record.Results: The rate of valid responses provided for each question was high, ranging from 84% to 100%. The questions with the highest number of patients selecting "do not know" and "prefer not to answer" pertained to disabilities and income. Patients reported finding the process acceptable. In subsequent implementation across 5 clinics, 10,536 patients have been surveyed; only 724 (6.9%) declined to participate.

show abstract

Differences in admission rates and outcomes between men and women presenting to emergency departments with coronary syndromes

Cited by 66 publications

References 31 publications

Acute Myocardial Infarction in Women

Acute Myocardial Infarction in Women

Age Difference Explains Gender Difference in Cardiac Intervention Rates After Acute Myocardial Infarction

Building a Foundation to Reduce Health Inequities: Routine Collection of Sociodemographic Data in Primary Care

Contact Info

Product

Resources

About