Gender disparities in percutaneous coronary interventions for acute myocardial infarction in Pennsylvania.
BACKGROUND
It has been shown that women are at greater risk than men of not receiving screening and treatment services for coronary heart disease. The purpose of this research was to determine whether there were gender disparities in the use of percutaneous coronary interventions (PCI) in the treatment of acute myocardial infarction (AMI) in Pennsylvania in 2000 and, if so, whether outcomes were affected.


METHODS
Data included 10,170 patients treated with PCI and 21,181 patients medically managed in Pennsylvania hospitals. Multivariate analyses were performed using logistic regression to estimate the impact of gender on PCI. In addition, we performed retrospective matching on propensity scores to compare outcomes for women who were treated with PCI to comparable groups of women and men.


RESULTS
After controlling for age, race/ethnicity, severity at admission, location of infarct, and source of admission, women had 24% lower odds than men of receiving PCI (P<0.0001). In a propensity score-matched sample of 3023 women who received PCI and 3023 women who did not, women who received PCI were significantly less likely to die (2.3% vs. 10.4%, P<0.0001). In a second propensity score-matched sample of 3329 women and 3329 similar men who received PCI, the difference in mortality was not statistically significant (1.59% vs. 1.92%, P=0.39).


CONCLUSIONS
These results suggest that the morbidity and mortality associated with AMI in women could be reduced by increased use of PCI and that more women admitted for AMI should receive consideration for PCI.
Hollenbeak
Christopher S
CS
Department of Surgery and Health Evaluation Sciences, Penn State College of Medicine, Hershey 17033, and Division of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania, USA. chollenbeak@psu.edu
Weisman
Carol S
CS
Rossi
Michael
M
Ettinger
Steven M
SM
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009203:Myocardial Infarction / Q000191:economics / Q000401:mortality / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010414:Pennsylvania; D012720:Severity of Illness Index; D012737:Sex Factors; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*