Women with Chest Pain Are Managed Differently Than Men

Women undergo fewer cardiac procedures than men. Are they also treated differently in working up a diagnosis of coronary artery disease? This prospective cohort study followed 1411 patients aged 30 or older presenting with chest pain to a teaching hospital emergency department.

After adjustment for many confounding variables -- including ECG findings, cardiac risk factors, and sociodemographic data -- women were less likely than men to be admitted to the hospital (57% vs. 70%; odds ratio, 0.68). Twenty-eight percent of women vs. 41% of men received a final diagnosis of acute ischemic heart disease. Among admitted patients, marginally fewer women had exercise stress testing and significantly fewer women were catheterized (11% vs. 21%; OR, 0.4…