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European Heart Journal Advance Access originally published online on February 8, 2005
European Heart Journal 2005 26(5):525; doi:10.1093/eurheartj/ehi121
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions{at}oupjournals.org

 

Revascularization for everyone?: reply

Christopher Cannon

Brigham and Women's Hospital
TIMI Study
350 Longwood Avenue, 1st floor
Boston, MA 02115 USA
Tel: +1 617 278 0146
Fax: +1 617 734 7329
E-mail address: cpcannon{at}partners.org

What Dr Redberg points out is a great area of debate–are there gender differences, over and above risk categories (i.e. by troponin status) that make outcomes different in women? In this acute coronary syndrome (ACS) population, we have differing results as she outlines, but the unifying feature of the studies is that when applying risk stratification, the higher-risk patients (male or female) benefit from the more aggressive therapies (in this case an invasive strategy, or GP IIb/IIIa inhibition). I personally do not use gender to withhold cardiac catheterization or antiplatelet therapy for patients, but I do base my treatment decisions on the patient's risk–using troponin, the ECG and the overall risk profile. Further research into this topic will certainly be very helpful in sorting this out. For now though, I focus on risk stratification to select therapies for ACS.1

References

  1. Cannon CP. Evidence-based risk stratification to target therapies in acute coronary syndromes. Circulation 2002;106:1588–1591.[Free Full Text]

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This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
26/5/525-a    most recent
ehi121v1
Right arrow E-letters: Submit a response
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