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Sex differences in investigation results and treatment in subjects referred for investigation of chest pain.
- Source :
-
Heart (British Cardiac Society) [Heart] 2001 Feb; Vol. 85 (2), pp. 149-52. - Publication Year :
- 2001
-
Abstract
- Objective: To evaluate differences in investigation results and treatment between men and women referred for diagnostic treadmill exercise testing and coronary arteriography.<br />Design: Cohort study.<br />Setting: Tertiary cardiology centre.<br />Subjects: 1522 subjects referred by primary care physicians to an open access chest pain clinic for initial investigation of chest pain, of whom 485 were subsequently referred for coronary arteriography; and a similar cohort of 107 subjects referred directly by secondary care physicians for diagnostic coronary arteriography.<br />Main Outcome Measures: Rates of positive exercise tests and rates for referral for arteriography and revascularisation according to sex.<br />Results: Overall, women were less likely to be referred for arteriography and revascularisation than men. However, men were more likely to have positive exercise tests, and for various exercise test diagnostic end points men were also more likely to have significant coronary artery disease. After taking this into account, there was no sex difference in referral rates for arteriography or revascularisation.<br />Conclusions: There was no evidence of a sex bias resulting in inappropriate underinvestigation or undertreatment of women. However, the positive predictive value of treadmill exercise testing is low for women and further research is needed into how best to investigate women with chest pain.
- Subjects :
- Aged
Cardiology Service, Hospital
Cohort Studies
Coronary Angiography
Coronary Disease therapy
England
Exercise Test
Female
Humans
Male
Middle Aged
Myocardial Revascularization
Pain Clinics
Predictive Value of Tests
Sex Factors
Chest Pain etiology
Coronary Disease diagnosis
Health Services Accessibility
Outcome and Process Assessment, Health Care
Prejudice
Referral and Consultation statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1468-201X
- Volume :
- 85
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Heart (British Cardiac Society)
- Publication Type :
- Academic Journal
- Accession number :
- 11156662
- Full Text :
- https://doi.org/10.1136/heart.85.2.149