Back to Search
Start Over
Systematic Review and Meta-analyses Investigating Whether Risk Stratification Explains Lower Rates of Coronary Angiography Among Women With Non–ST-Segment Elevation Acute Coronary Syndrome
- Source :
- Journal of Cardiovascular Nursing. 32:112-124
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Background: Guidelines recommend that all non–ST-segment elevation acute coronary syndrome (NSTEACS) patients with high-risk features receive a coronary angiogram. We hypothesised that the widely reported gender disparity in the use of angiography might be the result of women more frequently being stratified into the lower-risk category. Objectives: The aim of the study was to review studies reporting risk stratification of NSTEACS patients by gender, compare risk profiles, and assess impact on use of coronary angiography. Methods: PubMed, Scopus, and EMBASE databases were searched on June 17, 2014, using MeSH terms/subheadings and/or key words with no further limits. The search revealed 1230 articles, of which 25 met our objective. Results: Among the 28 risk-stratified populations described in the 25 articles, women were more likely to be stratified as high-risk in 13 studies; men were more likely to be stratified as high-risk in 3 studies. After meta-analyses, women had a 23% higher odds of being stratified as high-risk than did men (P = .001). Lower-risk patients were more likely to receive an angiogram in 15 study populations. Conclusions: Contrary to our hypothesis, this review showed that women with NSTEACS are more likely than men to be considered high-risk when stratified using a range of risk assessment methods. Lower rates of angiography in women form part of a broader treatment-risk paradox, which may involve gender bias in the selection of patients for invasive therapy.
- Subjects :
- medicine.medical_specialty
Acute coronary syndrome
Pathology
MEDLINE
risk stratification
030204 cardiovascular system & hematology
Coronary Angiography
Risk Assessment
acute coronary syndrome
Odds
angiogram
03 medical and health sciences
Sex Factors
0302 clinical medicine
Internal medicine
medicine
Humans
ST segment
030212 general & internal medicine
Non-ST Elevated Myocardial Infarction
Advanced and Specialized Nursing
medicine.diagnostic_test
business.industry
medicine.disease
meta-analyses
Meta-analysis
Angiography
Risk stratification
Female
women
Cardiology and Cardiovascular Medicine
Risk assessment
business
Subjects
Details
- ISSN :
- 15505049 and 08894655
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiovascular Nursing
- Accession number :
- edsair.doi.dedup.....a190abde1d0b7f9eacea2d970dda0a2a