Sex differences in guideline adherence for coronary angiography in patients with suspected chronic coronary syndrome in Germany: insights from the ENLIGHT-KHK trial.

IF 3.8 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Hannah Kentenich, Arim Shukri, Dirk Müller, Bastian Wein, Oliver Bruder, Stephanie Stock, Yana Kampfer
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引用次数: 0

Abstract

Background: For the management of acute coronary syndrome, literature shows lower healthcare providers' guideline adherence for women than for men. Since less is known about the management of chronic coronary syndrome (CCS), this study investigated patient-related sex differences in providers' guideline adherence for invasive coronary angiography (CA) performed in patients with suspected CCS.

Methods: Using data from the German ENLIGHT-KHK trial, patients with suspected CCS who underwent a CA were analysed. To assess the association between patient sex and physicians' adherence to the German National Disease Management Guideline "Chronic coronary artery disease" of 2019, binary logistic regression models were developed. Covariates included age, symptoms, risk factors, comorbidities, and non-invasive testing and its results. To examine sex differences in predictors of guideline adherence, models were run separately for women and men.

Results: Two hundred seventy-three women and three hundred eighty-six men were included (aged 67 ± 10 years). Physicians' guideline adherence for CA was lower for women than for men (19.4% vs. 30.1%, p = 0.002). CAs were less likely to be guideline-adherent for women with suspected CCS than men (OR 0.4, p < 0.05). Guideline adherence predictors differed between women and men. For example, men's predictors included non-invasive testing and its results, age, typical angina and smoking; of these, only a positive non-invasive test result had an impact for women.

Conclusion: Our results indicate a less guideline-adherent diagnostic workup of CA for women with suspected CCS than men. This might reflect a limited awareness of CCS in women and insufficiently sex-specific guideline recommendations.

Trial registration: German Clinical Trials Register DRKS00015638, Registered February 19, 2019; Universal Trial Number (UTN): U1111-1227-8055.

德国疑似慢性冠脉综合征患者冠状动脉造影指南依从性的性别差异:来自light - khk试验的见解
背景:对于急性冠状动脉综合征的治疗,文献显示女性医疗保健提供者的指南依从性低于男性。由于对慢性冠状动脉综合征(CCS)的管理知之甚少,本研究调查了在疑似CCS患者行有创冠状动脉造影(CA)时,提供者指南依从性的性别差异。方法:使用来自德国light - khk试验的数据,对行CA的疑似CCS患者进行分析。为了评估患者性别与医生遵守2019年德国国家疾病管理指南“慢性冠状动脉疾病”之间的关系,开发了二元逻辑回归模型。协变量包括年龄、症状、危险因素、合并症、非侵入性检测及其结果。为了检验指南依从性预测因子的性别差异,对女性和男性分别运行模型。结果:纳入女性273例,男性386例(年龄67±10岁)。医生对CA的指导依从性,女性低于男性(19.4%比30.1%,p = 0.002)。与男性相比,怀疑患有CCS的女性更不可能遵循指南(OR 0.4, p)。结论:我们的结果表明,怀疑患有CCS的女性的CA诊断工作比男性更不遵循指南。这可能反映了女性对CCS的认识有限,以及缺乏针对性别的指南建议。试验注册:德国临床试验注册号DRKS00015638,注册于2019年2月19日;通用试用号(UTN): U1111-1227-8055。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Research in Cardiology
Clinical Research in Cardiology 医学-心血管系统
CiteScore
11.40
自引率
4.00%
发文量
140
审稿时长
4-8 weeks
期刊介绍: Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.
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