ArticleBMJ (Clinical research ed.)2008
Inequity of access to investigation and effect on clinical outcomes: prognostic study of coronary angiography for suspected stable angina pectoris.
Article in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- South Asians and coronary disease: is there discordance between effects on incidence and prognosis?Heart (British Cardiac Society) · 2013Pooled it
- Evaluating the quality of research into a single prognostic biomarker: a systematic review and meta-analysis of 83 studies of C-reactive protein in stable coronary artery disease.PLoS medicine · 2010Pooled it
- Racism and Cardiology: A Global Call to Action.CJC open · 2021Review
- Appropriate referral and selection of patients with chronic pain for spinal cord stimulation: European consensus recommendations and e-health tool.European journal of pain (London, England) · 2020Article
- The Clinical Utility of a Precision Medicine Blood Test Incorporating Age, Sex, and Gene Expression for Evaluating Women with Stable Symptoms Suggestive of Obstructive Coronary Artery Disease: Analysis from the PRESET Registry.Journal of women's health (2002) · 2019Article
- Influences of socioeconomic deprivation on GPs' decisions to refer patients to cardiology: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Article
- Trends of relative and absolute socioeconomic equity in access to coronary revascularisations in 1995-2010 in Finland: a register study.International journal for equity in health · 2017Article
- Using decision trees for measuring gender equity in the timing of angiography in patients with acute coronary syndrome: a novel approach to equity analysis.International journal for equity in health · 2015Article
- Myocardial infarction incidence and survival by ethnic group: Scottish Health and Ethnicity Linkage retrospective cohort study.BMJ open · 2013Article
- Computed tomography coronary angiography accuracy in women and men at low to intermediate risk of coronary artery disease.European radiology · 2012Article
- Women and men with stable coronary artery disease have similar clinical outcomes: insights from the international prospective CLARIFY registry.European heart journal · 2012Article
- Inequalities in therapeutic treatment during cardiac inpatient rehabilitation in Germany.International journal of public health · 2012Article
- Article
- South Asians and coronary heart disease: always bad news?The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Article
- Angina in women.Current cardiology reports · 2010Review
- Universal health care no guarantee of equity: comparison of socioeconomic inequalities in the receipt of coronary procedures in patients with acute myocardial infarction and angina.BMC public health · 2009Article
- Chronic coronary artery disease: diagnosis and management.Mayo Clinic proceedings · 2009Review
- Women and ischemic heart disease: evolving knowledge.Journal of the American College of Cardiology · 2009 · on this mapReview
- Presentation of stable angina pectoris among women and South Asian people.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2008Article
- Universality, equity, and quality of care.BMJ (Clinical research ed.) · 2008Article
Corrections and comments
- Erratum issuedZaman, Justin [corrected to Zaman, M Justin].
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine whether coronary angiography for suspected stable angina pectoris is underused in older patients, women, south Asian patients, and those from socioeconomically deprived areas, and, if it is, whether this is associated with higher coronary event rates.
designMulticentre cohort with five year follow-up.
settingSix ambulatory care clinics in England.
participants1375 consecutive patients in whom coronary angiography was individually rated as appropriate with the Rand consensus method.
main outcome measuresReceipt of angiography (420 procedures); coronary mortality and acute coronary syndrome events.
resultsIn a multivariable analysis, angiography was less likely to be performed in patients aged over 64 compared with those aged under 50 (hazard ratio 0.60, 95% confidence interval 0.38 to 0.96), women compared with men (0.42, 0.35 to 0.50), south Asians compared with white people (0.48, 0.34 to 0.67), and patients in the most deprived fifth compared with the other four fifths (0.66, 0.40 to 1.08). Not undergoing angiography when it was deemed appropriate was associated with higher rates of coronary event.
conclusionsAt an early stage after presentation with suspected angina, coronary angiography is underused in older people, women, south Asians, and people from deprived areas. Not receiving appropriate angiography was associated with a higher risk of coronary events in all groups. Interventions based on clinical guidance that supports individualised management decisions might improve access and outcomes.
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