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Gender differences in use of invasive diagnostic and therapeutic procedures for acute ischaemic heart disease in Chinese adults
OBJECTIVE: To investigate gender differences in the use of diagnostic and therapeutic procedures for acute ischaemic heart disease (IHD) in Chinese adults and assess whether socioeconomic or health system factors contribute to such differences. METHODS: In 2004–2008, the China Kadoorie Biobank recru...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819660/ https://www.ncbi.nlm.nih.gov/pubmed/34045308 http://dx.doi.org/10.1136/heartjnl-2021-318988 |
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author | Levy, Muriel Chen, Yiping Clarke, Robert Guo, Yu Lv, Jun Yu, Canqing Li, Liming Chen, Zhengming Mihaylova, Borislava |
author_facet | Levy, Muriel Chen, Yiping Clarke, Robert Guo, Yu Lv, Jun Yu, Canqing Li, Liming Chen, Zhengming Mihaylova, Borislava |
author_sort | Levy, Muriel |
collection | PubMed |
description | OBJECTIVE: To investigate gender differences in the use of diagnostic and therapeutic procedures for acute ischaemic heart disease (IHD) in Chinese adults and assess whether socioeconomic or health system factors contribute to such differences. METHODS: In 2004–2008, the China Kadoorie Biobank recruited 512 726 adults from 10 diverse areas in China. Data for 38 928 first hospitalisations with IHD (2911 acute myocardial infarction (AMI), 9817 angina and 26 200 other IHD) were obtained by electronic linkage to health insurance records until 31 December 2016. Multivariate Poisson regression models were used to estimate women-to-men rate ratios (RRs) of having cardiac enzyme tests, coronary angiography and coronary revascularisation. RESULTS: Among the 38 928 individuals (61% women) with IHD admissions, women were less likely to have AMI (5% vs 12%), but more likely to have angina (26% vs 24%) or other IHD (69% vs 64%). For admissions with AMI, there were no differences in the use of cardiac enzymes between women and men (RR=1.00; 95% CI, 0.97 to 1.03), but women had lower use of coronary angiography (0.80, 0.68 to 0.93) and coronary revascularisation (0.85, 0.74 to 0.99). For angina, the corresponding RRs were: 0.97 (0.94 to 1.00), 0.66 (0.59 to 0.74) and 0.56 (0.47 to 0.67), respectively; while for other IHD, they were 0.97 (0.94 to 1.00), 0.87 (0.76 to 0.99) and 0.61 (0.51 to 0.73), respectively. Adjusting for socioeconomic and health system factors did not significantly alter the women-to-men RRs. CONCLUSIONS: Among Chinese adults hospitalised with acute IHD, women were less likely than men to have coronary angiography and revascularisation, but socioeconomic and health system factors did not contribute to these differences. |
format | Online Article Text |
id | pubmed-8819660 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-88196602022-02-16 Gender differences in use of invasive diagnostic and therapeutic procedures for acute ischaemic heart disease in Chinese adults Levy, Muriel Chen, Yiping Clarke, Robert Guo, Yu Lv, Jun Yu, Canqing Li, Liming Chen, Zhengming Mihaylova, Borislava Heart Healthcare Delivery, Economics and Global Health OBJECTIVE: To investigate gender differences in the use of diagnostic and therapeutic procedures for acute ischaemic heart disease (IHD) in Chinese adults and assess whether socioeconomic or health system factors contribute to such differences. METHODS: In 2004–2008, the China Kadoorie Biobank recruited 512 726 adults from 10 diverse areas in China. Data for 38 928 first hospitalisations with IHD (2911 acute myocardial infarction (AMI), 9817 angina and 26 200 other IHD) were obtained by electronic linkage to health insurance records until 31 December 2016. Multivariate Poisson regression models were used to estimate women-to-men rate ratios (RRs) of having cardiac enzyme tests, coronary angiography and coronary revascularisation. RESULTS: Among the 38 928 individuals (61% women) with IHD admissions, women were less likely to have AMI (5% vs 12%), but more likely to have angina (26% vs 24%) or other IHD (69% vs 64%). For admissions with AMI, there were no differences in the use of cardiac enzymes between women and men (RR=1.00; 95% CI, 0.97 to 1.03), but women had lower use of coronary angiography (0.80, 0.68 to 0.93) and coronary revascularisation (0.85, 0.74 to 0.99). For angina, the corresponding RRs were: 0.97 (0.94 to 1.00), 0.66 (0.59 to 0.74) and 0.56 (0.47 to 0.67), respectively; while for other IHD, they were 0.97 (0.94 to 1.00), 0.87 (0.76 to 0.99) and 0.61 (0.51 to 0.73), respectively. Adjusting for socioeconomic and health system factors did not significantly alter the women-to-men RRs. CONCLUSIONS: Among Chinese adults hospitalised with acute IHD, women were less likely than men to have coronary angiography and revascularisation, but socioeconomic and health system factors did not contribute to these differences. BMJ Publishing Group 2022-02 2021-05-27 /pmc/articles/PMC8819660/ /pubmed/34045308 http://dx.doi.org/10.1136/heartjnl-2021-318988 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Healthcare Delivery, Economics and Global Health Levy, Muriel Chen, Yiping Clarke, Robert Guo, Yu Lv, Jun Yu, Canqing Li, Liming Chen, Zhengming Mihaylova, Borislava Gender differences in use of invasive diagnostic and therapeutic procedures for acute ischaemic heart disease in Chinese adults |
title | Gender differences in use of invasive diagnostic and therapeutic procedures for acute ischaemic heart disease in Chinese adults |
title_full | Gender differences in use of invasive diagnostic and therapeutic procedures for acute ischaemic heart disease in Chinese adults |
title_fullStr | Gender differences in use of invasive diagnostic and therapeutic procedures for acute ischaemic heart disease in Chinese adults |
title_full_unstemmed | Gender differences in use of invasive diagnostic and therapeutic procedures for acute ischaemic heart disease in Chinese adults |
title_short | Gender differences in use of invasive diagnostic and therapeutic procedures for acute ischaemic heart disease in Chinese adults |
title_sort | gender differences in use of invasive diagnostic and therapeutic procedures for acute ischaemic heart disease in chinese adults |
topic | Healthcare Delivery, Economics and Global Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819660/ https://www.ncbi.nlm.nih.gov/pubmed/34045308 http://dx.doi.org/10.1136/heartjnl-2021-318988 |
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