9709291 心绞痛的发生率,临床特点和短期预后/Gandhi M M//Br Heart J.-1995,73(2).-193～200 津医情9709292 稳定型冠状动脉疾病患者清晨和日间暂时性心肌缺血基于不同的自主神经机制/van Boven A J//Br Heart J.-1995,73(2).-134～138
Background -We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. Methods and Results -The Euro Heart...Background -We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. Methods and Results -The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable angina on initial assessment by a cardiologist. Baseline clinical details and cardiac investigations planned or performed within a 4-week period of the assessment were recorded, and follow-up data were collected at 1 year. A total of 3779 patients were included in the survey; 42%were female. Women were less likely to undergo an exercise ECG(odds ratio, 0.81; 95%CI, 0.69 to 0.95) and less likely to be referred for coronary angiography(odds ratio, 0.59; 95%CI, 0.48 to 0.72). Antiplatelet and statin therapies were used significantly less in women than in men, both at initial assessment and at 1 year, even in those in whom coronary disease had been confirmed. Women with confirmed coronary disease were less likely to be revascularized than their male counterparts and were twice as likely to suffer death or nonfatal myocardial infarction during the 1-year follow-up period(hazard ratio, 2.09; 95%CI, 1.13 to 3.85), even after multivariable adjustment for age, abnormal ventricular function, severity of coronary disease, and diabetes. Conclusions -Significant gender bias has been identified in the use of investigations and evidence-based medical therapy in stable angina. Women were also less likely to be revascularized. The observed bias is of particular concern in light of the adverse prognosis observed among women with stable angina and confirmed coronary disease.展开更多
文摘9709291 心绞痛的发生率,临床特点和短期预后/Gandhi M M//Br Heart J.-1995,73(2).-193～200 津医情9709292 稳定型冠状动脉疾病患者清晨和日间暂时性心肌缺血基于不同的自主神经机制/van Boven A J//Br Heart J.-1995,73(2).-134～138
文摘Background -We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. Methods and Results -The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable angina on initial assessment by a cardiologist. Baseline clinical details and cardiac investigations planned or performed within a 4-week period of the assessment were recorded, and follow-up data were collected at 1 year. A total of 3779 patients were included in the survey; 42%were female. Women were less likely to undergo an exercise ECG(odds ratio, 0.81; 95%CI, 0.69 to 0.95) and less likely to be referred for coronary angiography(odds ratio, 0.59; 95%CI, 0.48 to 0.72). Antiplatelet and statin therapies were used significantly less in women than in men, both at initial assessment and at 1 year, even in those in whom coronary disease had been confirmed. Women with confirmed coronary disease were less likely to be revascularized than their male counterparts and were twice as likely to suffer death or nonfatal myocardial infarction during the 1-year follow-up period(hazard ratio, 2.09; 95%CI, 1.13 to 3.85), even after multivariable adjustment for age, abnormal ventricular function, severity of coronary disease, and diabetes. Conclusions -Significant gender bias has been identified in the use of investigations and evidence-based medical therapy in stable angina. Women were also less likely to be revascularized. The observed bias is of particular concern in light of the adverse prognosis observed among women with stable angina and confirmed coronary disease.
