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
Data(s) |
01/03/2017
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Resumo |
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. <br /><br />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. <br /><br />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. <br /><br />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. <br /><br />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. |
Identificador | |
Idioma(s) |
eng |
Publicador |
Lippincott Williams & Wilkins |
Relação |
http://dro.deakin.edu.au/eserv/DU:30080190/kuhn-systematicreview-2017.pdf http://dro.deakin.edu.au/eserv/DU:30080190/kuhn-systematicreview-inpress-2015.pdf http://www.dx.doi.org/10.1097/JCN.0000000000000300 |
Direitos |
2017, Wolters Kluwer Health |
Palavras-Chave | #acute coronary syndrome #angiogram #meta-analyses #risk stratification #women |
Tipo |
Journal Article |