Delayed diagnosis affects women's heart disease treatment

Women with heart disease receive less complete surgical revascularization with arterial grafts than men.

By Amy Wallace
A recent study found that delayed diagnosis, not gender, are factors driving women's treatment for heart disease. Photo by <a class="tpstyle" href="">TBIT/PixaBay</a>
A recent study found that delayed diagnosis, not gender, are factors driving women's treatment for heart disease. Photo by TBIT/PixaBay

Sept. 28 (UPI) -- A new study suggests delayed diagnosis, not gender, are the factors impacting women's treatment for heart disease.

The study, published today in The Annals of Thoracic Surgery, found that factors such as delayed diagnosis of coronary artery disease, or CAD, in women may be responsible for the differences in treatment.


"It appears that by the time women present with heart disease, they are slightly older and may be facing more comorbidities such as obesity and diabetes," Dr. Fraser D. Rubens, a researcher at the University of Ottawa Heart Institute in Canada, said in a press release. "As a consequence, these higher operative risks may preclude women from undergoing the more complex multiple arterial revascularization procedures that men receive."

Researchers used the Ottawa Heart Institute database of 19,557 patients who underwent coronary artery bypass grafting, or CABG, between January 1990 and March 2015. The team then narrowed the group down to 1,254 patients using 45 variables of similar characteristics.

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The study group was divided into 627 men and 627 women. Researchers found no real difference in the percentage of bilateral thoracic artery and radial artery use between men and women.


Researchers found that bilateral internal thoracic artery was used in 31.9 percent of men and 30.1 percent of women. Radial artery was used in 44.5 percent of men and 44.1 percent of women. Significantly less women received three arterial grafts compared with men, 7.3 percent to 10.5 percent respectively.

"Most clinicians assume correctly that women are less likely to receive multiple arterial revascularization, but they tend to believe that this is solely on the basis of a gender bias," Rubens said. "The current study shows that gender does not play a significant role in this decision. There is no reason that, when adjusted for all risk factors, the degree of multiple arterial revascularization in women should be any different than what men receive."

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The study showed that women with CAD are at a significant disadvantage compared with men because women do not consistently receive the same intensive, invasive evaluation and treatment as men.

Research showed men receive greater access to effective cardiac treatments including medications and revascularization.

"With earlier diagnoses, women could be referred for revascularization as healthier surgical candidates, affording them the opportunity of complete arterial revascularization strategies with better postoperative outcomes," Rubens said. "This study has given us the confidence to continue educating surgeons on the feasibility of multiple arterial revascularization and to ensure that this choice of surgical strategy be based on patient risk profiles and not solely on gender."


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