Sex disparities in procedure use for acute myocardial infarction in the United States, 1995 to 2001

Abstract

Background: Sex disparities in procedure use for acute myocardial infarction (AMI) have been well documented in selected populations in the 1980s and early 1990s. As little is known about more recent trends in sex disparities in the general population, we analyzed more recent rates of catheterization, angioplasty, and coronary artery bypass grafting (CABG) performed before discharge for acute myocardial infarction.

Methods: Data from representative civilian hospitals in 33 US states in the Nationwide Inpatient Sample from 1995 to 2001 were used to identify men and women discharged with a primary diagnosis of acute myocardial infarction. Receipt of cardiac catheterization, angioplasty, stent placement, or CABG was determined. Multivariate Poisson modeling was used to determine the likelihood of procedure receipt by sex, adjusting for demographic, comorbidity, and hospital characteristics.

Results: From 1995 to 2001, the adjusted proportion receiving catheterization, angioplasty, and stents increased in women as well as men, whereas the adjusted proportion receiving CABG declined slightly. Women were nearly as likely as men to undergo catheterization (adjusted prevalence ratio [PR], 0.96; 95% CI, 0.95 to 0.97), angioplasty (adjusted PR, 0.98; 95% CI, 0.97 to 0.99), or stent placement (adjusted PR, 0.96; 95% CI, 0.95 to 0.97). Women remained less likely to undergo CABG (adjusted PR, 0.78; 95% CI, 0.77 to 0.79).

Conclusions: These recent nationwide data suggest that compared with men, women are nearly as likely to undergo catheterization-based procedures but remain less likely to undergo CABG.