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Are we using cardiovascular medications and coronary angiography appropriately in men and women with chest pain?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. (Kardiologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. (Kardiologi)
2011 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 32, no 11, p. 1331-1336Article in journal (Refereed) Published
Abstract [en]

Aims The main purpose of the present study was to analyse the contemporary use of cardiovascular medications and diagnostic coronary angiography in men and women with suspected coronary artery disease (CAD). Furthermore, we examined the association of outcomes (death, myocardial infarction, repeat coronary angiography, procedural complications) with angiographic findings.

Methods All patients with stable chest pain (n = 12 200) referred for a first-time elective diagnostic coronary angiography during 2006-08 and registered in the Swedish Coronary Angiography and Angioplasty Register (SCAAR) were included. Significant CAD was defined as ≥50% luminal narrowing in any epicardial coronary artery.

Results In the youngest age group (≤59 years), more women than men (78.8 vs. 42.3%, P< 0.001) had normal/non-significant CAD, whereas more men had either left-main or three-vessel disease (18.2 vs. 4.2%, P < 0.001). Event rates were similarly low for men and women with normal/non-significant CAD, except for a higher procedural complication rate in women. Prior to angiography, fewer women than men with high-risk features were prescribed aspirin (83 vs. 86.1%, P = 0.001).

Conclusion In women, normal/non-significant CAD was highly prevalent, especially among younger women, and associated cardiovascular event rates were low. In men, findings of advanced disease were more common than in women, even younger men. Fewer high-risk women than men were initially prescribed aspirin. The observed sex differences suggest a need for improved identification of women appropriate for investigation with coronary angiography, earlier diagnostics in men, and heightened attention in the evidence-based use of aspirin in risk patients, especially women.

Place, publisher, year, edition, pages
2011. Vol. 32, no 11, p. 1331-1336
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-151798DOI: 10.1093/eurheartj/ehr009PubMedID: 21317147OAI: oai:DiVA.org:uu-151798DiVA, id: diva2:411350
Available from: 2011-04-18 Created: 2011-04-18 Last updated: 2017-12-11Bibliographically approved

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Johnston, NinaLagerqvist, Bo

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