Women may be less likely than men to receive optimal care at hospital discharge when admitted for coronary artery disease (CAD), according to a study published Feb. 23 in a special women’s issue of Circulation: Cardiovascular Quality and Outcomes.

The study, led by Deepak L. Bhatt, MD, MPH, FACC, looked at 49,358 patients ages 65 and older across 366 U.S. hospitals. Results showed that compared with men, women were less likely to receive optimal care, and were more likely to have higher mortality if sub-optimal care was received. Further, African-Americans, compared with whites, were also more likely to die from CAD, though this disparity could not be accounted for by differences in the quality of care.

The authors ultimately conclude that “approximately 69 percent of the sex disparity in mortality could potentially be reduced or greatly eliminated by providing optimal and equitable quality of care [to women].”

A separate study by Kim Lavoie, PhD, University of Quebec at Montreal, et al., found that anxiety symptoms might mask cardiovascular disease symptoms among women – but not men – and may contribute to referral and diagnostic delays for women.

The study looked at 2,342 patients who underwent a SPECT exercise stress test and underwent a psychiatric interview to assess mood and anxiety disorders. Results showed that in those without a history of CAD, women with anxiety were more likely to exhibit ischemia during exercise compared to women without anxiety. No significant effects were observed for men.

The authors conclude that moving forward, additional research is needed to confirm these findings, and that “Future work should also investigate the extent to which psychiatric disorders affect care trajectory and/or CAD outcomes among men and women, and whether interventions to improve psychiatric status among those with or at risk for CAD could improve outcomes.”

Keywords: African Americans, Anxiety, Anxiety Disorders, Coronary Artery Disease, Delayed Diagnosis, Exercise, Exercise Test, Referral and Consultation, Tomography, Emission-Computed, Single-Photon

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