Sex Differences in Evaluation and Outcome of Unstable Angina

Abstract

Sex differences in the delivery of cardiac care have been clearly documented.^1-11 Although considerable controversy remains concerning the appropriateness of such differences, there is evidence to suggest that once the diagnosis of coronary disease is established, such as after myocardial infarction (MI) or after coronary angiography, the delivery of cardiac care is similar for men and women.¹² Thus, it is of interest to examine sex differences at an earlier point in the diagnostic sequence, when the presence of coronary disease is not established. A recently published computerized survey of 720 primary care physicians indicated that sex independently influenced the management of chest pain,¹³ a frequent symptom in women and a frequent cause of emergency department (ED) visits. It is unknown whether a similar difference exists for patients receiving a diagnosis of unstable angina, and whether it affects outcomes.