|
| ||
|
|
||
Cardiac Risk Factors (cardiac + risk_factor)
Selected AbstractsCardiac Risk Factors and the Use of Triptans: A Survey StudyHEADACHE, Issue 7 2000William B. Young MD Objective.,To describe current practice in triptan use. Background.,Triptans are effective migraine treatments that cause chest symptoms in some patients. True cardiac ischemia is rare. Design.,Headache specialists and family practitioners completed questionnaires regarding the times when triptans are contraindicated, obtaining electrocardiograms (ECGs), and giving the first dose in the office. Results.,Sixty-five headache specialists and 67 family practitioners responded. Headache specialists saw an average of 36.3 patients with headache per week. Family practitioners saw an average of 7.2. Family practitioners and headache specialists had similar opinions regarding the age at which triptans were contraindicated with various numbers of risk factors. Sixty-one percent of headache specialists and 50% of family practitioners would not use a triptan at any age for patients with more than three risk factors (P = NS). Ten percent of headache specialists obtained an ECG for all patients being prescribed triptans, while no family practitioners did (P = .008). Ten percent of both family practitioners and headache specialists never obtained an ECG, even with multiple cardiac risk factors. Headache specialists obtained ECGs more often than family practitioners (P < .002 for one to three risk factors). Family practitioners were more likely to give the first dose of the triptan in the office regardless of cardiovascular risk (58% versus 20%, P < .001). Forty-five percent of headache specialists and 2% of family practitioners never gave the first dose in the office (P < .001). Family practitioners gave the first dose in the office more readily than headache specialists in patients with no risk factors (P = .001), but not for one or more risk factors. Conclusions.,No consensus exists among family practitioners or headache specialists about when to avoid using a triptan due to excessive cardiac risk factors, when to obtain an ECG prior to using a triptan, and when to give the first dose of a triptan in the office. Headache specialists are more likely to obtain ECGs, whereas family practitioners are more likely to give the first dose of a triptan in the office. [source] The Effect of Ethnicity on the Relationship Between Premature Coronary Artery Disease and Traditional Cardiac Risk Factors Among Uninsured Young AdultsPREVENTIVE CARDIOLOGY, Issue 3 2009Amit P. Amin MD Prior studies of premature coronary artery disease (CAD) in young adults did not address the association of race/ethnicity and risk factors. Therefore, the authors conducted a study of 400 patients 40 years and older undergoing coronary angiography at a large, urban public hospital that serves predominately minority, uninsured populations. The prevalence of risk factors and their association with premature CAD varied markedly by ethnic group. Among blacks, dyslipidemia, diabetes, and smoking were independently associated with premature CAD. Among Hispanics, dyslipidemia, male sex, and family history of CAD were independently associated with premature CAD. Smoking was the only risk factor in whites, and no independent risk factor was identified in Asian Indians. Whites and Asian Indians had a higher prevalence of disease than blacks or Hispanics,before and after adjusting for risk factor imbalances across ethnic groups. In this ethnically diverse population, the authors' findings underscore the importance of identifying distinctive risk factors in various ethnic groups. [source] Interdialytic blood pressure obtained by ambulatory blood pressure measurement and left ventricular structure in hypertensive hemodialysis patientsHEMODIALYSIS INTERNATIONAL, Issue 3 2008Siddig MOMINADAM Abstract Unlike in subjects with normal renal function, the relationship between hypertension and cardiovascular morbidity and mortality in dialysis patients is still being debated. In order to clarify this issue, we performed 44-hour ambulatory blood pressure measurements (ABPM) during the interdialytic period in a group of 164 hypertensive patients, the blood pressure (BP) control based on conventional antihypertensive strategy previously, on chronic hemodialysis treatment in the Mediterranean region of Turkey. These results were then compared with their echocardiographic data. This is a cross-sectional analysis. The mean ABPM during 44 hours was close to the manually measured predialysis value, but there was a gradual increase in the ABPM values in the interdialytic period. When divided into a group with mild or no left ventricular hypertrophy (LVH) (45 patients) and severe LVH (119 patients), the latter had significantly higher BP levels in all separate periods, while the difference in predialysis BP was not significant. Patients with severe LVH had larger left atrium and left ventricular diameters, and consumed more antihypertensive drugs. Systolic BP during the night before dialysis showed the strongest relation to LVH, but interdialytic weight gain was also independently related to LVH. Yet, 56% of the patients with systolic BP <135 had severe LVH. There is not only an association between BP and presence of LVH, but it is shown that volume expansion is also an important independent determinant of LVH. This may explain the difficulty in identifying hypertension as a cardiac risk factor in these patients. [source] Role of Dobutamine Stress Echocardiography for Preoperative Cardiac Risk Assessment Before Major Vascular Surgery: A Diagnostic Tool Comes of AgeECHOCARDIOGRAPHY, Issue 1 2000DON POLDERMANS M.D. Background: Cardiac complications are a major cause for perioperative mortality and morbidity Also, the presence and severity of underlying coronary artery disease (CAD) determine long-ten prognosis after successful surgery. Aim: This overview evaluates the additional value ofdobutamir, stress echocardiography (DSE) to common clinical cardiac risk factors and other noninvasii cardiac imaging modalities for perioperative and late cardiac prognosis. Results: DSE provides tl attending physician with preoperative prognostic information for perioperative and long-ten prognosis for cardiac events. It also enables the selection of high risk patients for evaluation i cardiac risk reduction therapies. Conclusions: DSE is a useful tool for preoperative cardiac ris evaluation in addition to common clinical cardiac risk factors. (ECHOCARDIOGRAPHY, Vo ume 17, January 2000) [source] Cardiac Risk Factors and the Use of Triptans: A Survey StudyHEADACHE, Issue 7 2000William B. Young MD Objective.,To describe current practice in triptan use. Background.,Triptans are effective migraine treatments that cause chest symptoms in some patients. True cardiac ischemia is rare. Design.,Headache specialists and family practitioners completed questionnaires regarding the times when triptans are contraindicated, obtaining electrocardiograms (ECGs), and giving the first dose in the office. Results.,Sixty-five headache specialists and 67 family practitioners responded. Headache specialists saw an average of 36.3 patients with headache per week. Family practitioners saw an average of 7.2. Family practitioners and headache specialists had similar opinions regarding the age at which triptans were contraindicated with various numbers of risk factors. Sixty-one percent of headache specialists and 50% of family practitioners would not use a triptan at any age for patients with more than three risk factors (P = NS). Ten percent of headache specialists obtained an ECG for all patients being prescribed triptans, while no family practitioners did (P = .008). Ten percent of both family practitioners and headache specialists never obtained an ECG, even with multiple cardiac risk factors. Headache specialists obtained ECGs more often than family practitioners (P < .002 for one to three risk factors). Family practitioners were more likely to give the first dose of the triptan in the office regardless of cardiovascular risk (58% versus 20%, P < .001). Forty-five percent of headache specialists and 2% of family practitioners never gave the first dose in the office (P < .001). Family practitioners gave the first dose in the office more readily than headache specialists in patients with no risk factors (P = .001), but not for one or more risk factors. Conclusions.,No consensus exists among family practitioners or headache specialists about when to avoid using a triptan due to excessive cardiac risk factors, when to obtain an ECG prior to using a triptan, and when to give the first dose of a triptan in the office. Headache specialists are more likely to obtain ECGs, whereas family practitioners are more likely to give the first dose of a triptan in the office. [source] Effectiveness of general practice nurse interventions in cardiac risk factor reduction among adultsINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 3 2007Elizabeth Halcomb RN BN(Hons) Grad Cert. Abstract Background, Cardiovascular disease is the leading cause of death for adults in Australia. In recent years there has been a shift in health service delivery from institutional to community-based care for chronic conditions, including cardiovascular disease. The general practice setting is seen to offer greater flexibility, higher levels of efficiency and more client focused healthcare delivery than is possible in the acute care sector. It has been suggested that practice nurses represent a useful adjunct to current models of cardiovascular disease management. To date, significant descriptive research has been conducted exploring the demographics, roles, educational needs and issues facing practice nurses. However, there is a need to evaluate the effectiveness of practice nurse interventions in terms of patient outcomes, clinician satisfaction and cost-effectiveness. Objectives, This review seeks to present the best available evidence regarding the efficacy of general practice nurse interventions for cardiac risk factor reduction in healthy adults, as well as those with established cardiovascular disease or known cardiac risk factors. Search Strategy, A systematic literature search was performed using Medline (1966 , 2005), CINAHL (1982 ,2005), Cochrane Controlled Trials Register (Issue 4, 2005) and the Joanna Briggs Institute Evidence Library. In addition, the reference lists of retrieved papers, conference proceedings and the Internet, were scrutinised for additional trials. Selection Criteria, This review considered any English language randomised trials that investigated interventions conducted by the practice nurse for cardiovascular disease management or reduction of cardiac risk factors. Interventions conducted by specialist cardiac nurses in general practice were excluded. Outcomes measured included blood pressure, smoking cessation, total cholesterol, exercise, body weight/body mass index and cost-effectiveness. Results, Eighteen trials, reported in 33 papers, were included in the review. Ten trials investigated multifaceted interventions, while the remaining eight trials reported targeted interventions. Of the trials that reported multifaceted interventions, three trials investigated risk reduction in those with established cardiovascular disease, four trials focused on those with known cardiovascular disease risk factors and three trials included the general community. The eight trials which examined the efficacy of targeted interventions focused upon dietary intake (two trials), smoking cessation (three trials), weight reduction (one trial) and physical activity (two trials). The effect of both the multifaceted and targeted interventions on patient outcomes was variable. However, both the multifaceted and targeted interventions demonstrated similar outcome trends for specific variables. Improvements were demonstrated by most studies in blood pressure, cholesterol level, dietary intake and physical activity. The variation in outcome measures and contradictory findings between some studies makes it difficult to draw definitive conclusions. Conclusions, While interventions to reduce cardiovascular disease risk factors have produced variable results, they offer significant potential to assist patients in modifying their personal risk profile and should be developed. The public health importance of these changes is dependant upon the sustainability of the change and its effect on the health outcomes of these individuals. Further well-designed research is required to establish the effectiveness of practice nurse interventions for cardiovascular disease management and risk factor reduction in terms of patient outcomes and cost-effectiveness. [source] Effectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart diseaseINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2005Tamara Page RN BN HyperbaricNursCert GradDipNSc(HighDep) MNSc Executive summary Background, Coronary heart disease is the major cause of illness and death in Western countries and this is likely to increase as the average age of the population rises. Consumers with established coronary heart disease are at the highest risk of experiencing further coronary events. Lifestyle measures can contribute significantly to a reduction in cardiovascular mortality in established coronary heart disease. Improved management of cardiac risk factors by providing education and referrals as required has been suggested as one way of maintaining quality care in patients with established coronary heart disease. There is a need to ascertain whether or not nurse-led clinics would be an effective adjunct for patients with coronary heart disease to supplement general practitioner advice and care. Objectives, The objective of this review was to present the best available evidence related to nurse-led cardiac clinics. Inclusion criteria, This review considered any randomised controlled trials that evaluated cardiac nurse-led clinics. In the absence of randomised controlled trials, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion. Participants were adults (18 years and older) with new or existing coronary heart disease. The interventions of interest to the review included education, assessment, consultation, referral and administrative structures. Outcomes measured included adverse event rates, readmissions, admissions, clinical and cost effectiveness, consumer satisfaction and compliance with therapy. Results, Based on the search terms used, 80 papers were initially identified and reviewed for inclusion; full reports of 24 of these papers were retrieved. There were no papers included that addressed cost effectiveness or adverse events; and none addressed the outcome of referrals. A critical appraisal of the 24 remaining papers identified a total of six randomised controlled trials that met the inclusion criteria. Two studies addressed nurse-led clinics for patients diagnosed with angina, one looked at medication administration and the other looked at educational plans. A further four studies compared secondary preventative care with a nurse-led clinic and general practitioner clinic. One specifically compared usual care versus shared care introduced by nurses for patients awaiting coronary artery bypass grafting. Of the remaining three studies, two have been combined in the results section, as they are an interim report and a final report of the same study. Because of inconsistencies in reporting styles and outcome measurements, meta-analysis could not be performed on all outcomes. However, a narrative summary of each study and comparisons of specific outcomes assessed from within each study has been developed. Although not all outcomes obtained statistical significance, nurse-led clinics were at least as effective as general practitioner clinics for most outcomes. Recommendations, The following recommendations are made: ,The use of nurse-led clinics is recommended for patients with coronary heart disease (Level II). ,Utilise nurse-led clinics to increase clinic attendance and follow-up rates (Level II). ,Nurse-led clinics are recommended for patients who require lifestyle changes to decrease their risk of adverse outcomes associated with coronary heart disease (Level II). [source] Risk factors of Hong Kong Chinese patients with coronary heart diseaseJOURNAL OF CLINICAL NURSING, Issue 7 2007Sek Ying Chair RN Aims and objectives., The aims of the study were to describe the level of modifiable coronary risk factors and to explore the relationships among these risk factors in patients with coronary heart disease. Background., Appropriate patient education and therapies for coronary risk reduction will prevent recurrent cardiac events and progression of coronary heart disease. Therefore, having knowledge of the risk profile of these patients is essential so that appropriate contents and focus of patient educations can be developed. Methods., Coronary heart disease patients admitted for cardiac catheterization at the two studied hospitals in Hong Kong were recruited for this study. Demographic date and risk factors of blood pressure, smoking status, body mass index, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and exercise level were collected from subjects as well as from medical records for analysis. Results., The body mass index was significantly different among non-smoker, ex-smoker and smoker (p = 0·027). Non-smokers had the highest body mass index but smokers had the lowest body mass index among the three groups in this study. Physical inactivity, overweight and hypercholesterolaemia were the risk factors seen in about 50% of the studied subjects. Body mass index correlated positively with systolic blood pressure but negatively correlated with high-density lipoprotein cholesterol and hour of exercise. Conclusions., Heavier subjects had a higher systolic blood pressure but a lower level of high-density lipoprotein cholesterol. Heavier subjects also exercised less. The study results provided additional information on the database of the risk profile among Hong Kong cardiac patients. Relevance to clinical practice., Hypertension, obesity, physical inactivity, abnormal serum lipid levels and smoking are the modifiable risk factors for coronary heart diseases. As physical inactivity, overweight and hypercholesterolaemia were found in half of the studied subjects, the importance of risk factors control should be addressed to this group of patients. Nurses should be aware of their educator role to provide appropriate education to coronary heart disease patients with the focus on reducing and controlling of cardiac risk factors, which has been shown to be effective in reducing the progress of disease. [source] Frequency of Acute Coronary Syndrome in Patients with Normal Electrocardiogram Performed during Presence or Absence of Chest PainACADEMIC EMERGENCY MEDICINE, Issue 6 2009Samuel D. Turnipseed MD Abstract Objectives:, The authors hypothesized that patients with active chest pain at the time of a normal electrocardiogram (ECG) have a lower frequency of acute coronary syndrome (ACS) than patients being evaluated for chest pain but with no active chest pain at the time of a normal ECG. The study objective was to describe the association between chest pain in patients with a normal ECG and the diagnosis of ACS. Methods:, This was a prospective observational study of emergency department (ED) patients with a chief complaint of chest pain and an initial normal ECG admitted to the hospital for chest pain evaluation over a 1-year period. Two groups were identified: patients with chest pain during the ECG and patients without chest pain during the ECG. Normal ECG criteria were as follow: 1) normal sinus rhythm with heart rate of 55,105 beats/min, 2) normal QRS interval and ST segment, and 3) normal T-wave morphology or T-wave flattening. "Normal" excludes pathologic Q waves, left ventricular hypertrophy, nonspecific ST-T wave abnormalities, any ST depression, and discrepancies in the axis between the T wave and the QRS. Patients' initial ED ECGs were interpreted as normal or abnormal by two emergency physicians (EPs); differences in interpretation were resolved by a cardiologist. ACS was defined as follows: 1) elevation and characteristic evolution of troponin I level, 2) coronary angiography demonstrating >70% stenosis in a major coronary artery, or 3) positive noninvasive cardiac stress test. Chi-square analysis was performed and odds ratios (ORs) are presented. Results:, A total of 1,741 patients were admitted with cardiopulmonary symptoms; 387 met study criteria. The study group comprised 199 males (51%) and 188 females (49%), mean age was 56 years (range, 25,90 years), and 106 (27%) had known coronary artery disease (CAD). A total of 261 (67%) patients experienced chest pain during ECG; 126 (33%) patients experienced no chest pain during ECG. There was no difference between the two groups in age, sex, cardiac risk factors, or known CAD. The frequency of ACS for the total study group was 17% (67/387). There was no difference in prevalence of ACS based on the presence or absence of chest pain (16% or 42/261 vs. 20% or 25/126; OR = 0.77, 95% confidence interval = 0.45 to 1.33, p = 0.4). Conclusions:, Contrary to our hypothesis concerning patients who presented to the ED with a chief complaint of chest pain, our study demonstrated no difference in the frequency of acute coronary syndrome between patients with chest pain at the time of acquisition of a normal electrocardiogram and those without chest pain during acquisition of a normal electrocardiogram. [source] P2.22: Association between erectil dysfunction and cardiac risk factors in Berlin men aged 40-79BIOMETRICAL JOURNAL, Issue S1 2004Heike Englert No abstract is available for this article. [source] Lipids, lipoproteins and the risk of benign prostatic hyperplasia in community-dwelling menBJU INTERNATIONAL, Issue 3 2008J. Kellogg Parsons OBJECTIVE To examine the associations of serum lipids and lipoproteins with benign prostatic hyperplasia (BPH) in community-dwelling men. SUBJECTS AND METHODS This analysis was conducted within the Rancho Bernardo Study, a prospective, community-based cohort study. BPH was defined as a history of prostate surgery for other than cancer, or a medical diagnosis of BPH. Logistic regression modelling, with adjustments for age and stratification by diabetes diagnosis, was used to estimate the odds ratio (OR) of BPH associated with fasting serum concentrations of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and the triglyceride to HDL ratio. RESULTS Among 531 eligible participants, 259 (48%) reported BPH and 272 (52%) reported no BPH. Men with BPH, with a mean (range) age of 75.8 (76.1,80.1) years, were older than men without BPH , at 72.7 (72.4,74.0) years. There were no significant associations of total cholesterol (P trend, 0.52), HDL cholesterol (0.56), triglycerides (0.30), or triglyceride to HDL ratio (0.13) with the risk of BPH. In a subset analysis in men with diabetes, those in the highest tertile (>133 mg/dL) of LDL cholesterol, compared with those in the lowest tertile (<110 mg/dL), were four times more likely to have BPH (odds ratio 4.00, 95% confidence interval 1.27,12.63, P trend 0.02). These results were not explained by the use of statins. CONCLUSIONS In these community-dwelling men, higher serum LDL was associated with a greater risk of BPH among diabetics. These data suggest that diabetic men with increased LDL cholesterol are at greater risk of BPH. This observation is consistent with the concept that cardiac risk factors are involved with the pathogenesis of BPH. [source] A Comparison of Door-to-balloon Times and False-positive Activations between Emergency Department and Out-of-hospital Activation of the Coronary Catheterization TeamACADEMIC EMERGENCY MEDICINE, Issue 8 2008Scott T. Youngquist MD Abstract Objectives:, The objectives were to compare the proportion of false-positive activations and intervention times between emergency department (ED) and field-based activation of the coronary catheterization laboratory (cath) team for emergency medical services (EMS) patients identified by out-of-hospital (OOH) 12-lead electrocardiogram (ECG) with ST-segment elevation myocardial infarction (STEMI). Methods:, This was a retrospective review of prospectively collected continuous quality improvement data at a single, urban, academic medical center. By protocol, weekday activation of the cath team occurred based on OOH notification of a computer-interpreted OOH ECG indicating potential STEMI. Night and weekend activation occurred at the discretion of the attending emergency physician (EP) after advanced ED notification and after patient arrival and assessment. Basic demographic information and cardiac risk factors were recorded, as well as door-to-balloon (DTB) and ultimate diagnosis. Results:, From May 2007 through March 2008, there were 23 field activations and 33 ED activations. There was no difference in demographic or clinical characteristics between the two groups. In the field activation group, 9/23 (39%) were false-positives, while 3/33 (9%) were false-positives in the ED activation group (30% higher absolute difference in the field activation group, 95% confidence interval [CI] = 8% to 52%, p = 0.02). OOH times and time spent in the ED were similar between the two groups. DTB times were 77 minutes for field activation and 68 minutes for ED activation, respectively (difference 9 minutes, 95% CI = ,9 to 27). Conclusions:, Emergency physician activation of the cath team results in a lower proportion of false-positive activations without clearly sacrificing DTB time when compared to field activation based solely on the results of the OOH ECG. [source] Subclinical late cardiac toxicity in childhood cancer survivorsCANCER, Issue 8 2008Impact on self-reported health Abstract BACKGROUND The authors analyzed how self-reported health and self-reported modified New York Heart Association (NYHA) cardiac function scores were related to cardiac systolic function, cardiac risk factors, and cancer treatment history in childhood cancer survivors who reported no symptoms of cardiac disease. METHODS Long-term survivors of pediatric cancer who were treated between 1971 and 1995 (current ages, 16,39.7 years) underwent noninvasive clinical and laboratory cardiac risk evaluation and responded to selected subscales of the Medical Outcomes Study 36-item Short Form Health Survey. Results were compared with survivor history of anthracycline therapy alone or with radiotherapy (n = 127 patients; mean, 10 years after diagnosis) versus no anthracycline therapy (n = 32 patients; mean, 11 years after diagnosis). RESULTS Sex, current age, highest school grade completed, race, age at diagnosis, diagnostic group, years off therapy, fractional shortening (FS), heart rate, and smoking status were found to be independently predictive of self-reported health. Interaction between female sex and higher low-density lipoprotein values and between diagnosis and abnormal FS variably predicted low reported vitality and low reported modified New York Heart Association (NYHA) scores. Echocardiographic findings, cardiac risk factors, and treatment history explained 13% to 28% of the variance in perceived health and self-reported modified NYHA scores. CONCLUSIONS Systolic function and cardiac risk factors were linked to lower self-reported health and NYHA scores even in the absence of clinically evident cardiotoxicity. Cancer 2008. ©2008 American Cancer Society. [source] Gender Bias in Cardiovascular Testing Persists after Adjustment for Presenting Characteristics and Cardiac RiskACADEMIC EMERGENCY MEDICINE, Issue 7 2007Anna Marie Chang MD Objectives:Previous studies have found that female patients receive fewer invasive tests for cardiovascular disease than male patients. The authors assessed whether different clinical characteristics at emergency department presentation account for this gender bias. Methods:Patients with potential acute coronary syndrome (ACS) who presented to a university hospital were prospectively identified. A structured data instrument that included demographic information, chest pain description, history, physical examination, chest radiography, and electrocardiogram (ECG) data was completed. Hospital course was tracked daily. Patients received 30-day telephone follow-up. The main outcome was whether the patients received objective evaluation for coronary artery disease after adjustment for cardiac risk, including race, age, total number of risk factors, Thrombolysis in Myocardial Infarction (TIMI) score, ECG, and whether the patient sustained an acute myocardial infarction on index hospitalization. Results:There were 3,514 women (58%) and 2,547 men (42%) studied. They had similar presenting characteristics: chest pain quality (pressure/tightness: female 60% vs. male 59%, p = 0.6), location (substernal: female 82% vs. male 80%; p = 0.2), radiation (female 27% vs. male 26%; p = 0.3), and most associated symptoms. Men had more cardiac risk factors (mean 1.5 vs 1.4; p < 0.001), more abnormal ECGs (59% vs. 48%; p < 0.001), and a higher TIMI risk score (p < 0.001). With respect to the main outcome, men received more cardiac catheterizations (12.6% vs. 6.0%; odds ratio [OR], 2.25; 95% confidence interval [CI] = 1.88 to 2.70) and more stress tests (14.7% vs. 12.3%; OR, 1.22; 95% CI = 1.05 to 1.42). After adjustment for age, race, cardiac risk factors, ECG, and TIMI risk score, men still received more cardiac catheterizations (adjusted OR, 1.72; 95% CI = 1.40 to 2.11) and stress tests (adjusted OR, 1.16; 95% CI = 1.01 to 1.33). Models adjusting for acute myocardial infarction or death, high-risk initial clinical impression, or emergency department disposition found similar results for increased likelihood of cardiac catheterization in men but no difference in stress testing between men and women. Conclusions:Female patients with potential ACS receive fewer cardiac catheterizations than male patients, even when presenting complaint, history, ECG, and diagnosis are taken into account. The gender bias cannot be explained by differences in presentation or clinical course. [source] | ||||||||||