Sex-based analysis of NSTEMI processes of care and outcomes by hospital: a nationwide cohort study
Authors' conclusion
There was a significant variation in the management of patients with NSTEMI according to sex, with widespread geographical variation.
Study context
- Population
- NSTEMI admissions in the United Kingdom (UK) Myocardial Ischaemia National Audit Project (MINAP) registry, 2010–17
- Participants
- 305,014 NSTEMI admissions
- Exposure
- Women vs men
- Womenn = 110,209
- Outcome
- Invasive management (coronary angiography and PCI) by sex
Methodological detailsnationwide, hierarchical multivariate logistic regression, hospital-clustered analysis
- Nationwide
- Hierarchical multivariate logistic regression
- Hospital-clustered analysis
Main finding
As reported in the abstract
Invasive coronary angiogram
P < 0.001
PCI
P < 0.001
Observational data: associations, not effects.
Further findings
Baseline characteristics
Age Women 77 years · Men 69 years
Caucasian
- Baseline characteristics: age P < 0.001
- Baseline characteristics: Caucasian P < 0.001
Hospital risk-standardized mortality rates (RSMR) vs proportion of women treated for NSTEMI (hospital-clustered)
- Positive correlation, R2 = 0.17
- P < 0.001
Hospital RSMR vs proportion with optimum OBQI score
- Women: negative correlation, R2 = 0.22
- P < 0.001
- Men: weaker correlation, R2 = 0.08
- P < 0.001
Regional OBQI score (heat maps by Clinical Commissioning Group (CCG))
- Significant regional variation in OBQI score, with women receiving poorer quality care throughout the UK
Original publication
Sex-based analysis of NSTEMI processes of care and outcomes by hospital: a nationwide cohort study. Eur Heart J Qual Care Clin Outcomes. Published 6 February 2024. doi:10.
Summarised from the published abstract; every number is checked against it