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ATLANTA (Reuters Health) - In what appears to be a huge shift in clinical practice, women with suspected heart disease are being referred for cardiac catheterization twice as often as men, according to a new study.
Cardiac catheterization is a procedure that enables doctors to locate and open possible coronary artery blockages with the aim of preventing heart attacks and death. The procedure involves passing a long, thin, flexible tube known as a catheter typically through the upper thigh and into the heart, allowing doctors to do diagnostic cardiac tests and treatments.
For years, men have been much more likely than women to be referred for cardiac catheterization, but it appears that times are changing, said Dr. Marcelo Di Carli, from Brigham and Women's Hospital in Boston. "A lot of effort has been put into raising awareness about heart disease in women. It appears now that this is beginning to bear fruit.
"Di Carli and his colleagues analyzed referral rates in 891 women and 812 men who had heart imaging tests. These tests were abnormal in 30 percent of women and 22 percent of men. The researchers found that 10 percent of patients overall were referred for cardiac catheterization within 90 days -- and referral rates were higher in women (13 percent) than in men (6 percent).
"The big question now is whether this increased referral to cath reflects overuse, appropriate use, or under-use in men," said Di Carli, who presented the findings at the American College of Cardiology meeting. "This was something we could not answer because we don't have a standard of appropriateness for referral to cath.
"What does seem to be happening is that the long-standing bias against women and heart disease is reversing, he said."Physicians may be more aware that women present with more atypical symptoms and recognize that those symptoms may reflect coronary disease. People are starting to pay more attention," Di Carli said.