INFLUENCE OF SEX ON THE USE OF CARDIAC PROCEDURES IN PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT - A PROSPECTIVE MULTICENTER STUDY

Background Reports about the use of cardiac procedures have produced c onflicting results as to whether there is a sex bias in the use of thr ombolytic therapy, cardiac catheterization, or revascularization proce dures. The present study was undertaken with the hope of resolving som e of these different findings by examining the use of these therapies in women and men who presented to the emergency department with sympto ms suggestive of acute cardiac ischemia. Methods and Results During 7 consecutive months in 1993, 10 673 individuals greater than or equal t o 30 years old who presented with chest pain or other symptoms suggest ive of acute cardiac ischemia were enrolled in the Acute Cardiac Ische mia Time-Insensitive Predictive Instrument Clinical Trial at 10 hospit als in the East and Midwest. This study included 2542 patients (24% of all patients) who had confirmed acute myocardial infarction or angina pectoris. There were significant sex differences with respect to demo graphic and clinical characteristics and the use of cardiac procedures . Among patients with acute myocardial infarction, the use of thrombol ytic therapy, cardiac catheterization, and revascularization procedure s was similar in women and men after multivariate adjustment. However, in the group with angina pectoris, women were considerably less likel y to undergo these procedures, even after adjustment for significant b aseline covariates. Conclusions Women with angina pectoris were less l ikely to undergo cardiac catheterization or revascularization procedur es, although unmeasured factors could in part explain the observed dif ferences.