title: Gender differences in therapeutic recommendation after diagnostic coronary angiography: insights from the Coronary Angiography and PCI Registry of the German Society of Cardiology.
abstract: BACKGROUND
  There is information suggesting differences and underuse of invasive coronary diagnostic and therapeutic procedures in women compared to men.
  
  
  METHODS
  Data from consecutive patients (pts) which were enrolled in the Coronary Angiography and PCI Registry of the German Society of Cardiology were analyzed. We compared gender-related differences in diagnosis and therapeutic recommendation of pts undergoing coronary angiography (XA) for stable coronary artery disease (CAD), non-ST elevation acute coronary syndromes (NSTE-ACS) and ST elevation myocardial infarction (STEMI).
  
  
  RESULTS
  From 2004 until the end of 2009, data of 1,060,542 invasive procedures in 1,014,996 pts were prospectively registered. One-third (34.6%) of them were female. Women less often had significant CAD, irrespective of the indication for XA. In pts with relevant CAD, percutaneous coronary interventions (PCI) were recommended in 87.1% of women versus 89.1% of men with STEMI [age-adjusted OR (aOR) 0.98, 95% CI 0.93-1.04], in 67.1 vs. 66.8% in NSTE-ACS (aOR 1.10, 1.07-1.12), and in 50.3 vs 49.4% in stable CAD (aOR 1.07, 1.05-1.09).
  
  
  CONCLUSIONS
  In pts with significant CAD, there was no difference in recommendation for PCI between the genders in stable CAD, whereas in STEMI and NSTE-ACS women were treated even more often with PCI. There were only minor differences in referral for CABG between women and men. Hence, our data provide strong evidence against a gender bias in use of invasive therapeutic procedures once the diagnosis of significant CAD has been confirmed.
authors: Department of Cardiology, Krankenhaus Agatharied, Academic Teaching Hospital, University of Munich, Norbert-Kerkel-Platz, 83607, Hausham, Germany, tobias.heer@khagatharied.de.
authors: Tobias
authors: T
authors: Heer
authors: Matthias
authors: M
authors: Hochadel
authors: Karin
authors: K
authors: Schmidt
authors: Julinda
authors: J
authors: Mehilli
authors: Ralf
authors: R
authors: Zahn
authors: Karl-Heinz
authors: KH
authors: Kuck
authors: Christian
authors: C
authors: Hamm
authors: Michael
authors: M
authors: Böhm
authors: Georg
authors: G
authors: Ertl
authors: Dietrich
authors: D
authors: Andresen
authors: Steffen
authors: S
authors: Massberg
authors: Jochen
authors: J
authors: Senges
authors: Günter
authors: G
authors: Pilz
authors: Anselm K
authors: AK
authors: Gitt
authors: Uwe
authors: U
authors: Zeymer
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005858:Germany; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data; D011446:Prospective Studies; D012042:Registries; D012737:Sex Factors