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Sex Differences in Cardiac Catheterization after Acute Myocardial Infarction: The Role of Procedure Appropriateness

Saif S. Rathore, MPH; Yongfei Wang, MS; Martha J. Radford, MD; Diana L. Ordin, MD, MPH; and Harlan M. Krumholz, MD, SM
[+] Article and Author Information

From Yale University School of Medicine, New Haven, Connecticut; Yale–New Haven Hospital, New Haven, Connecticut; Qualidigm, Middletown, Connecticut; and Centers for Medicare & Medicaid Services, Boston, Massachusetts.


Disclaimer: The content of this publication does not necessarily reflect the views or policies of the U.S. Department of Health and Human Services, nor does mention of trade names, commercial products, or organization imply endorsement by the U.S. government. The author assumes full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Centers for Medicare & Medicaid Services (formerly Health Care Financing Administration), which has encouraged identification of quality improvement projects derived from analysis of patterns of care and, therefore, required no special funding on the part of this contractor.

Acknowledgments: The authors thank Maria Johnson, BA, for editorial assistance and Jeph Herrin, PhD, for statistical assistance.

Grant Support: By the Centers for Medicare & Medicaid Services (CMS, formerly the Health Care Financing Administration), U.S. Department of Health and Human Services (contract number 500-99-CTO1: “Utilization and Quality Control Peer Review Organization for the State of Connecticut”).

Corresponding Author: Harlan Krumholz, MD, Department of Internal Medicine, Room IE-61 SHM, Yale University School of Medicine, 333 Cedar Street, PO Box 208025, New Haven, CT 06520-8025; email, harlan.krumholz@yale.edu.

Current Author Addresses: Mr. Rathore, Mr. Wang, and Drs. Radford and Krumholz: Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, Room I-456 SHM, PO Box 208025, New Haven, CT 06520-8025.

Dr. Ordin: Centers for Medicare & Medicaid Services Boston Regional Office, Government Center, JFK Federal Building, Room 2350, Boston, MA 02203.

Author Contributions: Conception and design: S.S. Rathore, H.M. Krumholz.

Analysis and interpretation of the data: S.S. Rathore, Y. Wang, H.M. Krumholz.

Drafting of the article: S.S. Rathore.

Critical revision of the article for important intellectual content: S.S. Rathore, Y. Wang, M.J. Radford, D.L. Ordin, H.M. Krumholz.

Final approval of the article: S.S. Rathore, Y. Wang, M.J. Radford, D.L. Ordin, H.M. Krumholz.

Provision of study materials or patients: H.M. Krumholz.

Statistical expertise: S.S. Rathore, Y. Wang, H.M. Krumholz.

Obtaining of funding: M.J. Radford, H.M. Krumholz.

Administrative, technical, or logistic support: M.J. Radford, D.L. Ordin, H.M. Krumholz.


Ann Intern Med. 2002;137(6):487-493. doi:10.7326/0003-4819-137-6-200209170-00008
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Patients were predominantly white, the mean age was 77 years, and 51% of the patients were men. Compared with men, women were older and were more likely to be black and to have hypertension, diabetes, congestive heart failure, dementia, and limited functional status. However, women were less likely to have had a previous myocardial infarction or to have undergone previous cardiac procedures. Women were also more likely to have been admitted from a nursing home, more likely to have been treated at a smaller-volume hospital, and less likely to have been treated by a cardiologist or board-certified physician (Table 2).

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Summary for Patients

Do Women with Heart Attacks Get Fewer Heart Procedures Than Men?

The summary below is from the full report titled “Sex Differences in Cardiac Catheterization after Acute Myocardial Infarction: The Role of Procedure Appropriateness.” It is in the 17 September 2002 issue of Annals of Internal Medicine (volume 137, pages 487-493). The authors are SS Rathore, Y Wang, MJ Radford, DL Ordin, and HM Krumholz.

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