Universität zu Köln

Kentenich, Hannah ORCID: 0000-0002-5331-9256, Shukri, Arim ORCID: 0000-0003-3709-3493, Müller, Dirk ORCID: 0000-0002-5576-0192, Wein, Bastian ORCID: 0000-0003-1146-6757, Bruder, Oliver ORCID: 0000-0003-2531-5503, Stock, Stephanie ORCID: 0000-0002-1726-9300 and Kampfer, Yana ORCID: 0000-0001-7260-6384 (2025). Sex differences in guideline adherence for coronary angiography in patients with suspected chronic coronary syndrome in Germany: insights from the ENLIGHT-KHK trial. Clinical Research in Cardiology, 114 (12). pp. 1718-1729. Springer Nature. ISSN 1861-0684

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Abstract

Background: For the management of acute coronary syndrome, literature shows lower healthcare providers’ guideline adherence for women than for men. Since less is known about the management of chronic coronary syndrome (CCS), this study investigated patient-related sex differences in providers’ guideline adherence for invasive coronary angiography (CA) performed in patients with suspected CCS. Methods: Using data from the German ENLIGHT-KHK trial, patients with suspected CCS who underwent a CA were analysed. To assess the association between patient sex and physicians’ adherence to the German National Disease Management Guideline “Chronic coronary artery disease” of 2019, binary logistic regression models were developed. Covariates included age, symptoms, risk factors, comorbidities, and non-invasive testing and its results. To examine sex differences in predictors of guideline adherence, models were run separately for women and men. Results: Two hundred seventy-three women and three hundred eighty-six men were included (aged 67 ± 10 years). Physicians’ guideline adherence for CA was lower for women than for men (19.4% vs. 30.1%, p = 0.002). CAs were less likely to be guideline-adherent for women with suspected CCS than men (OR 0.4, p < 0.05). Guideline adherence predictors differed between women and men. For example, men’s predictors included non-invasive testing and its results, age, typical angina and smoking; of these, only a positive non-invasive test result had an impact for women. Conclusion: Our results indicate a less guideline-adherent diagnostic workup of CA for women with suspected CCS than men. This might reflect a limited awareness of CCS in women and insufficiently sex-specific guideline recommendations. Trial registration: German Clinical Trials Register DRKS00015638, Registered February 19, 2019; Universal Trial Number (UTN): U1111-1227-8055.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Kentenich, Hannah UNSPECIFIED https://orcid.org/0000-0002-5331-9256 UNSPECIFIED Shukri, Arim UNSPECIFIED https://orcid.org/0000-0003-3709-3493 UNSPECIFIED Müller, Dirk UNSPECIFIED https://orcid.org/0000-0002-5576-0192 UNSPECIFIED Wein, Bastian UNSPECIFIED https://orcid.org/0000-0003-1146-6757 UNSPECIFIED Bruder, Oliver UNSPECIFIED https://orcid.org/0000-0003-2531-5503 UNSPECIFIED Stock, Stephanie UNSPECIFIED https://orcid.org/0000-0002-1726-9300 UNSPECIFIED Kampfer, Yana UNSPECIFIED https://orcid.org/0000-0001-7260-6384 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-801833
Identification Number:	10.1007/s00392-025-02655-y
Journal or Publication Title:	Clinical Research in Cardiology
Volume:	114
Number:	12
Page Range:	pp. 1718-1729
Number of Pages:	12
Date:	6 December 2025
Publisher:	Springer Nature
ISSN:	1861-0684
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Gesundheitsökonomie > Institut für Gesundheitsökonomie und Klinische Epidemiologie
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Coronary artery disease ; Coronary angiography ; Sex differences ; Guideline adherence English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80183