Inequitable Access to Coronary Angiography Linked with Higher Rates of Coronary Events and Death

Many studies have shown that ethnic minorities, women, elders, and the poor have less access than others to effective interventions for stable angina and acute coronary syndromes. Does reduced access lead to worse cardiac outcomes? In a 5-year multicenter cohort study, investigators reviewed medical records of 10,634 patients with recent onset angina who visited “rapid access chest pain clinics” in the U.K.

An independent panel determined that 1375 patients were appropriate candidates for coronary angiography. Of these, only 420 patients (31%) underwent the procedure. In multivariate analysis, coronary angiography was significantly less likely to be performed in patients aged 65 and older (compared with patients younger than 50), in women (c…