Treatment for women with heart problems is less vigorous, study finds

• The results of our study showed that women, especially high-risk women, aren't receiving the recommended treatment for patients with acute coronary syndromes," said Sonia S. Anand, MD, PhD, FRCPc, associate professor of medicine at McMaster University in Hamilton, Ontario, Canada, and lead author of the paper.
• Dr. Anand, who holds the May Cohen Eli Lilly Chair in Women's Health Research at McMaster, spoke today at the American Medical Association's 24th annual Science Reporters Conference in Washington, D.C. She and her coauthors analyzed data from the Clopidogrel in Unstable Angina Evaluation (CURE) trial, a study of 4,836 women and 7,726 men with ACS, a group of conditions that includes angina, or chest pain, and certain types of heart attacks.
• The patients, from 28 countries, were recruited between December 1998 and September 2000.
• The problem started, Dr. Anand said, when women with ACS weren't sent for diagnostic tests, such as coronary angiography, during which physicians use a catheter to inject dye into the arteries to identify blockages.
• Overall, 15 percent fewer women underwent angiography, and 20 percent fewer high-risk women than high-risk men had the test.
• "Maybe women refuse procedures more than men, maybe there is a bias that causes physicians to feel that men are high-risk so they should have procedures and not women, or maybe women have different chest pain symptoms than men," she said.
• Dr. Anand is working to find the root of the problem through several new studies, including an online survey of physicians who are presented with patient scenarios and asked to respond with a treatment plan.
• By observing whether physicians would treat identical patients differently depending on gender, she hopes to shed light on the issue of physician bias.