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dc.contributor.authorMorgan-Hughes, Gen
dc.contributor.authorWilliams, MCen
dc.contributor.authorLoudon, Men
dc.contributor.authorRoobottom, CAen
dc.contributor.authorIacovides, Sen
dc.contributor.authorWotton, Fen
dc.contributor.authorVeitch, Aen
dc.contributor.authorSchmitt, Men
dc.contributor.authorBull, Ren
dc.date.accessioned2021-10-14T13:03:37Z
dc.date.issued2021-06-02en
dc.identifier.issn2053-3624en
dc.identifier.othere001672en
dc.identifier.urihttp://hdl.handle.net/10026.1/18069
dc.description.abstract

<jats:sec><jats:title>Objective</jats:title><jats:p>We surveyed UK practice of National Institute for Health and Care Excellence (NICE) “Recent onset chest pain” guidance (CG95, 2016), stratified by sex. We looked for sex-related differences in referral to computed tomographic coronary angiography (CTCA) and subsequent functional imaging (FI), invasive coronary angiography (ICA) and revascularisation.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This was a prospective analysis of CTCA practice in 8 UK centres between 2018 and 2020. Coronary artery disease (CAD) was recorded with the CAD-reporting and data system. Local electronic records/archiving/communication systems were used to collect data regarding subsequent FI, ICA and revascularisation.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>2301 women, 2326 men underwent CTCA; women were older (58±11 vs 55±12 years, p&lt;0.001) but more likely to have normal coronary arteries (46% (1047) vs 29% (685); p&lt;0.001) and less likely to have severe stenosis (7% (169) vs 13% (307); p&lt;0.001). FI was used less for 4% (93) women, 5% (108) men; ICA was also used less for women (8% (182) vs 14% (321)), as was revascularisation (4% (83) vs 8% (177), p&lt;0.001 for all), including those with ≥moderate CTCA stenosis undergoing ICA (53% (79) vs 61% (166); p&lt;0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Women referred for a NICE CG95 (2016) CTCA are more likely to have normal coronary arteries and men more likely to have CAD. More men than women will then undergo ICA and revascularisation even after adjustments for CTCA disease severity. Raised awareness of these inequalities may improve contemporary chest pain care.</jats:p></jats:sec>

en
dc.languageenen
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.titleSex-based inequalities in contemporary UK hospital management of stable chest painen
dc.typeJournal Article
plymouth.issue1en
plymouth.volume8en
plymouth.journalOpen Hearten
dc.identifier.doi10.1136/openhrt-2021-001672en
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine/UoA01 Clinical Medicine
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dcterms.dateAccepted2021-05-19en
dc.rights.embargodate2021-10-15en
dc.identifier.eissn2053-3624en
dc.rights.embargoperiodNot knownen
rioxxterms.versionofrecord10.1136/openhrt-2021-001672en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2021-06-02en
rioxxterms.typeJournal Article/Reviewen


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