Recorded presentation

Christopher S. Hollenbeak, PhD, Surgery and Health Evaluation Sciences, Penn State College of Medicine, 500 University Drive, H113, Hershey, PA 17033, 717-531-5890, chollenbeak@psu.edu, Carol S. Weisman, PhD, Department of Health Evaluation Sciences, A210, Penn State College of Medicine, 600 Centerview Drive, Suite 2200, Hershey, PA 17033-0855, Michael A. Rossi, MD, Medicine, Lehigh Valley Hospital, Cedar Crest & I-78, Allentown, PA 10103, and Steven M. Ettinger, MD, Division of Cardiology, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033.

Purpose. The purpose of this research was to determine whether there were gender disparities in the use of PCI in the treatment of AMI in Pennsylvania and, if so, whether outcomes were affected.

Methods. We performed a retrospective analysis of a statewide database. Data were provided by the Pennsylvania Health Care Cost Containment Council (PHC4). Multivariate analyses of in hospital mortality were performed using binary logistic regression, controlling for relevant covariates. Retrospective matching on propensity scores was performed using a “greedy” matching algorithm.

Results. During the year 2000, 10,170 (32.4%) AMI patients were treated with PCI and 21,181 (67.6%) patients were medically managed in Pennsylvania hospitals. Women were significantly less likely to be treated with PCI than men (23.9% vs. 40%, p<0.0001) and were also more likely to die in the hospital (12.7% vs. 9.7%, p<0.0001). At hospitals where PCI was available, women were significantly less likely than men to receive it (34.4% vs. 65.4%, p<0.0001). They were also more likely to die when treated at hospitals offering PCI (10.1% women vs. 7.3% men, p<0.0001). These disparities in treatment and outcomes were confirmed in multivariate analyses. Finally, we used propensity score methods to match 3,022 women who received PCI to 3,022 women who did not. Results showed that women who received PCI were significantly less likely to die during their hospitalization (2.4% vs. 10.7%, p<0.0001)

Conclusions. In the Commonwealth of Pennsylvania, women appear to be less likely to receive primary PCI for treatment of AMI. Furthermore, women who received this form of therapy experienced better outcomes.

Learning Objectives: At the conclusion of this presentation, participants will

• understand the gender disparities in treatment for AMI in Pennsylvania, and
• how outcomes are affected by this disparity.

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Dr. Hollenbeak has consulted for the Pennsylvania Health Care Cost Containment Council (PHC4).

Recorded presentation