Lack of sex disparity in cardiovascular testing after coronary computerized tomographic angiography

Catherine T. Ginty, Anna Marie Chang, Asako C. Matsuura, Christopher Decker, Jeffrey Le, Michael Green, Harold I. Litt, Judd E. Hollander

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: The authors assessed whether there was a sex disparity in testing of patients after coronary computerized tomographic angiography (CTA) was performed for emergency department (ED) patients with potential acute coronary syndromes (ACS). In theory, once coronary anatomy has been determined, any disparity in subsequent workup should not be the result of differences in presentation. Methods: This was a prospective cohort study of ED patients who presented with potential ACS and received coronary CTAs at a university hospital. Demographics, history, cardiac risk factors, follow-up testing, and procedures were recorded. Follow-up at 30 days was obtained by structured record review and telephone contact. Patients were stratified by sex and coronary CTA results (max stenosis: none, 1% to 24%, 25% to 49%, 50% to 69%, and ¥70%). Main outcome was the relative risk (RR) of a male receiving a stress test or catheterization within 30 days, stratified by categories of percent maximal stenosis. Results: A total of 1,144 patients received coronary CTAs (mean ± SD age = 47.8 ± 8.7 years), 55% were female, and 64% were black or African American. Overall, 161 patients received follow-up testing within 30 days, 113 during their index visit. Men were more likely to receive further testing (RR = 1.51; 95% confidence interval [CI] = 1.14 to 1.99) compared to women. However, when stratified by percentage of stenosis, men were not more likely to receive further testing within 30 days after coronary CTA compared to women (RR = 1.14; 95% CI = 0.68 to 1.91). In multivariable modeling for risk of further testing, stenosis remained significant (adjusted relative risk [aRR] = 1.51; 95% CI = 1.19 to 1.91), while male sex, age, race, and Thrombolysis in Myocardial Infarction (TIMI) risk score were not. Conclusions: Male patients with potential ACS who receive a coronary CTA as a part of their ED evaluation were no more likely than female patients to receive further testing within 30 days.

Original languageEnglish (US)
Pages (from-to)147-152
Number of pages6
JournalAcademic Emergency Medicine
Volume19
Issue number2
DOIs
StatePublished - Feb 2012
Externally publishedYes

Fingerprint

Angiography
Pathologic Constriction
Acute Coronary Syndrome
Hospital Emergency Service
Confidence Intervals
Exercise Test
Telephone
Catheterization
African Americans
Anatomy
Cohort Studies
History
Myocardial Infarction
Demography
Prospective Studies

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Ginty, C. T., Chang, A. M., Matsuura, A. C., Decker, C., Le, J., Green, M., ... Hollander, J. E. (2012). Lack of sex disparity in cardiovascular testing after coronary computerized tomographic angiography. Academic Emergency Medicine, 19(2), 147-152. https://doi.org/10.1111/j.1553-2712.2011.01286.x

Lack of sex disparity in cardiovascular testing after coronary computerized tomographic angiography. / Ginty, Catherine T.; Chang, Anna Marie; Matsuura, Asako C.; Decker, Christopher; Le, Jeffrey; Green, Michael; Litt, Harold I.; Hollander, Judd E.

In: Academic Emergency Medicine, Vol. 19, No. 2, 02.2012, p. 147-152.

Research output: Contribution to journalArticle

Ginty, CT, Chang, AM, Matsuura, AC, Decker, C, Le, J, Green, M, Litt, HI & Hollander, JE 2012, 'Lack of sex disparity in cardiovascular testing after coronary computerized tomographic angiography', Academic Emergency Medicine, vol. 19, no. 2, pp. 147-152. https://doi.org/10.1111/j.1553-2712.2011.01286.x
Ginty, Catherine T. ; Chang, Anna Marie ; Matsuura, Asako C. ; Decker, Christopher ; Le, Jeffrey ; Green, Michael ; Litt, Harold I. ; Hollander, Judd E. / Lack of sex disparity in cardiovascular testing after coronary computerized tomographic angiography. In: Academic Emergency Medicine. 2012 ; Vol. 19, No. 2. pp. 147-152.
@article{1d0d12fe78ed490497b27d29ecf5b0e4,
title = "Lack of sex disparity in cardiovascular testing after coronary computerized tomographic angiography",
abstract = "Objectives: The authors assessed whether there was a sex disparity in testing of patients after coronary computerized tomographic angiography (CTA) was performed for emergency department (ED) patients with potential acute coronary syndromes (ACS). In theory, once coronary anatomy has been determined, any disparity in subsequent workup should not be the result of differences in presentation. Methods: This was a prospective cohort study of ED patients who presented with potential ACS and received coronary CTAs at a university hospital. Demographics, history, cardiac risk factors, follow-up testing, and procedures were recorded. Follow-up at 30 days was obtained by structured record review and telephone contact. Patients were stratified by sex and coronary CTA results (max stenosis: none, 1{\%} to 24{\%}, 25{\%} to 49{\%}, 50{\%} to 69{\%}, and ¥70{\%}). Main outcome was the relative risk (RR) of a male receiving a stress test or catheterization within 30 days, stratified by categories of percent maximal stenosis. Results: A total of 1,144 patients received coronary CTAs (mean ± SD age = 47.8 ± 8.7 years), 55{\%} were female, and 64{\%} were black or African American. Overall, 161 patients received follow-up testing within 30 days, 113 during their index visit. Men were more likely to receive further testing (RR = 1.51; 95{\%} confidence interval [CI] = 1.14 to 1.99) compared to women. However, when stratified by percentage of stenosis, men were not more likely to receive further testing within 30 days after coronary CTA compared to women (RR = 1.14; 95{\%} CI = 0.68 to 1.91). In multivariable modeling for risk of further testing, stenosis remained significant (adjusted relative risk [aRR] = 1.51; 95{\%} CI = 1.19 to 1.91), while male sex, age, race, and Thrombolysis in Myocardial Infarction (TIMI) risk score were not. Conclusions: Male patients with potential ACS who receive a coronary CTA as a part of their ED evaluation were no more likely than female patients to receive further testing within 30 days.",
author = "Ginty, {Catherine T.} and Chang, {Anna Marie} and Matsuura, {Asako C.} and Christopher Decker and Jeffrey Le and Michael Green and Litt, {Harold I.} and Hollander, {Judd E.}",
year = "2012",
month = "2",
doi = "10.1111/j.1553-2712.2011.01286.x",
language = "English (US)",
volume = "19",
pages = "147--152",
journal = "Academic Emergency Medicine",
issn = "1069-6563",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Lack of sex disparity in cardiovascular testing after coronary computerized tomographic angiography

AU - Ginty, Catherine T.

AU - Chang, Anna Marie

AU - Matsuura, Asako C.

AU - Decker, Christopher

AU - Le, Jeffrey

AU - Green, Michael

AU - Litt, Harold I.

AU - Hollander, Judd E.

PY - 2012/2

Y1 - 2012/2

N2 - Objectives: The authors assessed whether there was a sex disparity in testing of patients after coronary computerized tomographic angiography (CTA) was performed for emergency department (ED) patients with potential acute coronary syndromes (ACS). In theory, once coronary anatomy has been determined, any disparity in subsequent workup should not be the result of differences in presentation. Methods: This was a prospective cohort study of ED patients who presented with potential ACS and received coronary CTAs at a university hospital. Demographics, history, cardiac risk factors, follow-up testing, and procedures were recorded. Follow-up at 30 days was obtained by structured record review and telephone contact. Patients were stratified by sex and coronary CTA results (max stenosis: none, 1% to 24%, 25% to 49%, 50% to 69%, and ¥70%). Main outcome was the relative risk (RR) of a male receiving a stress test or catheterization within 30 days, stratified by categories of percent maximal stenosis. Results: A total of 1,144 patients received coronary CTAs (mean ± SD age = 47.8 ± 8.7 years), 55% were female, and 64% were black or African American. Overall, 161 patients received follow-up testing within 30 days, 113 during their index visit. Men were more likely to receive further testing (RR = 1.51; 95% confidence interval [CI] = 1.14 to 1.99) compared to women. However, when stratified by percentage of stenosis, men were not more likely to receive further testing within 30 days after coronary CTA compared to women (RR = 1.14; 95% CI = 0.68 to 1.91). In multivariable modeling for risk of further testing, stenosis remained significant (adjusted relative risk [aRR] = 1.51; 95% CI = 1.19 to 1.91), while male sex, age, race, and Thrombolysis in Myocardial Infarction (TIMI) risk score were not. Conclusions: Male patients with potential ACS who receive a coronary CTA as a part of their ED evaluation were no more likely than female patients to receive further testing within 30 days.

AB - Objectives: The authors assessed whether there was a sex disparity in testing of patients after coronary computerized tomographic angiography (CTA) was performed for emergency department (ED) patients with potential acute coronary syndromes (ACS). In theory, once coronary anatomy has been determined, any disparity in subsequent workup should not be the result of differences in presentation. Methods: This was a prospective cohort study of ED patients who presented with potential ACS and received coronary CTAs at a university hospital. Demographics, history, cardiac risk factors, follow-up testing, and procedures were recorded. Follow-up at 30 days was obtained by structured record review and telephone contact. Patients were stratified by sex and coronary CTA results (max stenosis: none, 1% to 24%, 25% to 49%, 50% to 69%, and ¥70%). Main outcome was the relative risk (RR) of a male receiving a stress test or catheterization within 30 days, stratified by categories of percent maximal stenosis. Results: A total of 1,144 patients received coronary CTAs (mean ± SD age = 47.8 ± 8.7 years), 55% were female, and 64% were black or African American. Overall, 161 patients received follow-up testing within 30 days, 113 during their index visit. Men were more likely to receive further testing (RR = 1.51; 95% confidence interval [CI] = 1.14 to 1.99) compared to women. However, when stratified by percentage of stenosis, men were not more likely to receive further testing within 30 days after coronary CTA compared to women (RR = 1.14; 95% CI = 0.68 to 1.91). In multivariable modeling for risk of further testing, stenosis remained significant (adjusted relative risk [aRR] = 1.51; 95% CI = 1.19 to 1.91), while male sex, age, race, and Thrombolysis in Myocardial Infarction (TIMI) risk score were not. Conclusions: Male patients with potential ACS who receive a coronary CTA as a part of their ED evaluation were no more likely than female patients to receive further testing within 30 days.

UR - http://www.scopus.com/inward/record.url?scp=84856817705&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856817705&partnerID=8YFLogxK

U2 - 10.1111/j.1553-2712.2011.01286.x

DO - 10.1111/j.1553-2712.2011.01286.x

M3 - Article

VL - 19

SP - 147

EP - 152

JO - Academic Emergency Medicine

JF - Academic Emergency Medicine

SN - 1069-6563

IS - 2

ER -