Inequitable Access to Early Angiography Affects Outcome

For some groups, coronary angiography is underutilized, raising risk of adverse events

FRIDAY, April 25 (HealthDay News) -- Although early access to coronary angiography for patients presenting with suspected angina reduces the risk of coronary events, it is underused in older people, women, South Asians and people from socially deprived areas, according to a study published online April 24 in the BMJ.

Neha Sekhri, MRCP, of Barts and the London NHS Trust in London and colleagues conducted a study of 1,375 patients for whom coronary angiography was individually rated as appropriate with the Rand consensus method. The authors looked at the number of patients who actually received angiography, coronary mortality and the incidence of acute coronary events.

Among the 420 patients who received angiography, patients older than 64 were underrepresented when compared with those younger than 50. Similar disparities were noted between men and women, between South Asians and white people, and between patients from the most socially deprived quintile and patients from the other four quintiles. Higher rates of coronary events were seen among patients who did not undergo angiography at the appropriate time.

"Some variation in use of coronary angiography might result from patients' choices not to undergo the procedure, which could vary systematically by demographic group," the authors write. "There is a role for further qualitative research to elucidate why patients who are deemed appropriate for coronary angiography do not receive it."

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