New Study in Women’s Health Issues: Gender Differences in Treatment of Acute Coronary Syndrome Patients

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WASHINGTON, DC (December 15, 2015) – Women admitted to hospitals in the Australian state of Victoria with acute coronary syndrome (ACS) were less likely to receive coronary interventions, found a study published today in the journal Women’s Health Issues, the official journal of the Jacobs Institute of Women’s Health, which is based at Milken Institute School of Public Health at the George Washington University.

Linda Worrall-Carter, of Her Heart Ltd and Australian Catholic University, and her colleagues analyzed data on all 28,295 patients admitted to Victoria hospitals with a first-time primary diagnosis of ACS between June 2007 and July 2009. They report that women, who accounted for 36 percent of the patients, were less likely than men to receive three common kinds of invasive coronary interventions: angiograms, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG).  

Worrall-Carter and her colleagues examined several factors that can affect treatments and outcomes in ACS patients, including the number of other health conditions recorded for each patient and the type of ACS. They categorized patients as having either STEMI (ST-segment elevation myocardial infarction) or NSTEACS (non–ST-segment elevation ACS, which includes non-STEMI and unstable angina). Compared to men, they found women were more likely to be age 75 or older, have multiple other health conditions, and be diagnosed with NSTEACS.

Even after adjusting for factors such as age, other health conditions, and type of ACS, Worrall-Carter and colleagues found that women were around one-half as likely to be treated with an invasive coronary intervention – and the in-hospital death rate was higher in patients who did not receive these interventions. While their unadjusted analysis found a higher rate of in-hospital death for women, the difference disappeared after adjustment.

The frequent decision to not refer women ACS patients for angiography means that clinicians may miss opportunities to provide early revascularization treatment, the authors warn. They conclude, “Clinicians should be wary of inherent gender bias in decisions to refer patients for angiography.”

 The article, “Gender Differences in Presentation, Coronary Intervention, and Outcomes of 28,985 Acute Coronary Syndrome Patients in Victoria, Australia,” appears in the January/February 2016 issue of Women’s Health Issues.

About Women’s Health Issues:
Women's Health Issues is the official publication of the Jacobs Institute of Women's Health, and the only journal devoted exclusively to women's health care and policy issues. The journal has a particular focus on women's issues in the context of the U.S. health care delivery system and policymaking processes, although it invites submissions addressing women's health care issues in global context if relevant to North American readers. It is a journal for health professionals, social scientists, policymakers, and others concerned with the complex and diverse facets of health care delivery and policy for women. For more information about the journal, please visit

About Milken Institute School of Public Health at the George Washington University:
Established in July 1997 as the School of Public Health and Health Services, Milken Institute School of Public Health is the only school of public health in the nation’s capital. Today, more than 1,700 students from almost every U.S. state and 39 countries pursue undergraduate, graduate and doctoral-level degrees in public health. The school also offers an online Master of Public Health, MPH@GW, and an online Executive Master of Health Administration, MHA@GW, which allow students to pursue their degree from anywhere in the world.