BACKGROUND: over the last decade, there have been major changes in the treatment of ST-elevation myocardial infarction (STEMI). Whether these have resulted in changes in sex differences in time to treatment is unknown. We examined temporal trends in time to reperfusion therapy among men and women with STEMI. METHODS: the study includes 2 cohorts of STEMI patients presenting to a large metropolitan region during the periods August 24, 2000, to August 20, 2002 (Cohort1, n = 753), and August 25, 2006, to December 31, 2008 (Cohort2, n = 885). RESULTS: in both cohorts, compared with men, women were significantly older and had more comorbidities. Rate of emergency medical services use among women increased from 55% in Cohort1 to 66% in Cohort2 (P = .02). Median time from symptom onset to first medical contact was 84 minutes among men and 121 minutes among women (P < .01) in Cohort1 and 59 minutes among men and 81 minutes among women (P < .01) in Cohort2. Median door-to-balloon time was significantly longer among women compared with men in Cohort2. After multivariable adjustment, female sex was associated with a 34% (or 27-minute) increase in time from symptom onset to first medical contact and with a 23% (or 13-minute) increase in time from hospital arrival to reperfusion therapy. CONCLUSIONS: in the last decade, there have been significant reductions in patient and system delay, especially among women. However, women continue to have longer presentation and treatment times, suggesting that there continue to be opportunities for improvement.
RCT Entities:
BACKGROUND: over the last decade, there have been major changes in the treatment of ST-elevation myocardial infarction (STEMI). Whether these have resulted in changes in sex differences in time to treatment is unknown. We examined temporal trends in time to reperfusion therapy among men and women with STEMI. METHODS: the study includes 2 cohorts of STEMI patients presenting to a large metropolitan region during the periods August 24, 2000, to August 20, 2002 (Cohort1, n = 753), and August 25, 2006, to December 31, 2008 (Cohort2, n = 885). RESULTS: in both cohorts, compared with men, women were significantly older and had more comorbidities. Rate of emergency medical services use among women increased from 55% in Cohort1 to 66% in Cohort2 (P = .02). Median time from symptom onset to first medical contact was 84 minutes among men and 121 minutes among women (P < .01) in Cohort1 and 59 minutes among men and 81 minutes among women (P < .01) in Cohort2. Median door-to-balloon time was significantly longer among women compared with men in Cohort2. After multivariable adjustment, female sex was associated with a 34% (or 27-minute) increase in time from symptom onset to first medical contact and with a 23% (or 13-minute) increase in time from hospital arrival to reperfusion therapy. CONCLUSIONS: in the last decade, there have been significant reductions in patient and system delay, especially among women. However, women continue to have longer presentation and treatment times, suggesting that there continue to be opportunities for improvement.
Authors: Roxanne Pelletier; Karin H Humphries; Avi Shimony; Simon L Bacon; Kim L Lavoie; Doreen Rabi; Igor Karp; Meytal Avgil Tsadok; Louise Pilote Journal: CMAJ Date: 2014-03-17 Impact factor: 8.262
Authors: Amber M Otten; Angela H E M Maas; Jan Paul Ottervanger; Anita Kloosterman; Arnoud W J van 't Hof; Jan Henk E Dambrink; A T Marcel Gosselink; Jan C A Hoorntje; Harry Suryapranata; Menko Jan de Boer Journal: Eur Heart J Acute Cardiovasc Care Date: 2013-01-31
Authors: Sreyram Kuy; Anahita Dua; Sapan S Desai; Peter J Rossi; Gary R Seabrook; Brian D Lewis; Bhavin Patel; Sreyreath Kuy; Cheong J Lee; Rishi Subbarayan; Kellie R Brown Journal: Ann Vasc Surg Date: 2013-12-07 Impact factor: 1.466
Authors: Ersilia M DeFilippis; Bradley L Collins; Avinainder Singh; David W Biery; Amber Fatima; Arman Qamar; Adam N Berman; Ankur Gupta; Mary Cawley; Malissa J Wood; Josh Klein; Jon Hainer; Martha Gulati; Viviany R Taqueti; Marcelo F Di Carli; Khurram Nasir; Deepak L Bhatt; Ron Blankstein Journal: Eur Heart J Date: 2020-11-07 Impact factor: 29.983