Abstract 12974: Sex Differences in Invasive Coronary Angiography at a Large Urban US Hospital

Abstract

Introduction: Invasive coronary angiography (ICA) is a common procedure to evaluate for ischemic heart disease. Significant sex differences in referral for invasive coronary angiography as well as intervention have been reported. The aim of the current study was to evaluate the impact of male and female sex on patterns of ICA at a large urban hospital. Methods: We retrospectively reviewed hospital procedures performed at UF Health Jacksonville between 2014 and 2018. The electronic health record was queried. Total number of cases and number of cases who did not undergo percutaneous coronary intervention (PCI) or coronary artery bypass graft at the same encounter were retrieved. Chi-square was used to compare groups and odds ratio with 95% confidence interval calculated, and a p-value <0.05 was considered statistically significant. Results: A total of 5556 patients underwent ICA with a men (n=3307) to women (n=2249) ratio of 1.47. Similarly, the ratios of fractional flow reserve (FFR) and intravascular ultrasound (IVUS) were lower in women as compared to men. The mean age for male patients was 61±12 years and <3% were <40 years old. The mean age for female patients was 62±13 years and <3% were <40 years old. Female gender was significantly associated with lower likelihood of having intervention with a male versus female odds ratio (OR) of 1.5 [95% CI 1.4-1.7, p <0.001]. However, those females who underwent PCI had the same ratio of receiving balloon angioplasty, stents or atherectomy as compared to males. Conclusion: In a large urban US clinical center with a diverse and underserved population, being a woman significantly decreases the likelihood of referral for ICA as well as PCI. Our study aligns with prior investigations and underscores the need for further studies to clarify the underlying causes of these differences.