Gender differences in diagnosis and treatment of coronary artery disease from 1981 to 1997. No evidence for the Yentl syndrome
| Autor: | E. E. van der Wall, A. V. G. Bruschke, A. A. Voors, H.E Westerveld, A. H. Zwinderman, J. E. Roeters Van Lennep, H.W.O. Roeters van Lennep, H. W. M. Plokker |
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| Přispěvatelé: | Internal Medicine, Radiotherapy, Pulmonary Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2000 |
| Předmět: |
Male
medicine.medical_specialty Eponyms medicine.medical_treatment Coronary Disease Anterior Descending Coronary Artery Coronary Angiography Revascularization Coronary artery disease Coronary artery bypass surgery Sex Factors Risk Factors Angioplasty medicine.artery Internal medicine medicine Humans Angioplasty Balloon Coronary Coronary Artery Bypass Referral and Consultation Aged business.industry Syndrome Middle Aged medicine.disease Stenosis medicine.anatomical_structure Right coronary artery Cardiology Female Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | European Heart Journal, 21(11), 911-918. Oxford University Press |
| ISSN: | 0195-668X |
| Popis: | Aims. The aim of the present clinical study was to evaluate whether gender-related differences existed as regards the extent and localization of coronary artery lesions in patients with angiographically documented coronary artery disease, and whether these angiographic findings would lead to differences in further management. Methods and results. Over a 16-year period (1981-1997) we evaluated 1894 patients (1526 men, 368 women) with angiographically documented coronary artery disease (luminal stenosis ≥ 60%). For each patient the coronary angiographic results and subsequent revascularization procedures (percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery) were analysed. The study period was divided into the early angioplasty years (1981 to 1989) and the current angioplasty years (1990-1997). No gender differences in extent and localization of coronary angiographic lesions were observed. In men and women the incidence of single-vessel disease was 42% and 40%, two-vessel disease 27% and 27%, three-vessel disease 26% and 24%, and left main disease 5% and 8%, respectively (P = ns). Localization of disease in men and women was 36% and 39% for the left anterior descending coronary artery, 34% and 32% for the right coronary artery, and 27% and 26% for the left circumflex coronary artery, respectively (P = ns). There was a significant shift from multi-vessel disease towards single-vessel disease in both men and women (both P < 0.001). As to subsequent management, a significant gender difference in favour of women was observed (P = 0.021). Over time, the number of angioplasty procedures increased significantly from 11.6% to 23.2% for men (P < 0.001), and for women from 17.6% to 28.0% (P = 0.025), whereas the number of coronary artery bypass procedures decreased in men from 34.9% to 29.5% (P = 0.024) and in women from 42.6% to 30.6% (P = 0.019). Referral to angioplasty (n = 535) and coronary artery bypass surgery (n = 616) in relation to the extent of the disease did not show any gender bias in favour of men. Conclusions. Our angiographic findings did not show significant gender differences as regards the extent and localization of coronary artery disease in patients with angiographically documented coronary artery disease. More importantly, no substantial evidence could be found for under-referral of women to subsequent therapeutic management. Therefore our study questions the presence of Yentl syndrome in the current era. (C) 2000 The European Society of Cardiology. |
| Databáze: | OpenAIRE |
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