Andre R Duraes1,2, Yasmin Sl Bitar3, Ana Carolina T Freitas4, Ivan Mp Filho5, Beatriz C Freitas4, Andre Ms Fernandez2,6. 1. Assistant Professor of Medical Semiology/Universidade Federal da BahiaSalvador - BA, 41180-780, Brazil. 2. Specialist in Cardiology/Brazilian Society of CardiologySalvador - BA, 41180-780, Brazil. 3. Bachelor of Health, Universidade Federal da BahiaSalvador - BA, 41180-780, Brazil. 4. Medical Student/Universidade do Estado da BahiaSalvador - BA, 41180-780, Brazil. 5. Hospital and Emergency Coordinator in Salvador-BrazilSalvador - BA, 41180-780, Brazil. 6. Doctor of Medicine and Health/Federal University of BahiaSalvador - BA, 41180-780, Brazil.
Abstract
BACKGROUND: Delays in attending to ST-elevation myocardial infarction (STEMI) are indicators or markers of quality of health services. Several records suggest gender disparity in cardiac care as a contributor to the increased mortality among women. METHODS: We prospectively enrolled all consecutive STEMI patients who were transferred to our hospital from January through December 2015. The following variables were analyzed: Symptom-to-Door Time (SDT); Time to First ECG (TECG); Transfer Time to Referring Center (TTRC); and Door-to-Cath lab time (DCT). RESULTS: Of the 133 patients, 85 (63.9%) were male and 45 (36%) female. The mean age and body mass index (BMI) between the male and female genders were 56.3 and 60.5 years for the first and 26 and 27.7 Kg/M2 for the second. Diabetes and low school education level were more prevalent in women than men, with statistical significance: 20 (48.8%) vs 18 (26.1%) with P = 0.01 and 26 (54.2%) vs 28 (32.9%) with P = 0.04, respectively. Regarding the times evaluated (SDT, TECG, TTRC and DCT), there was no statistically significant difference in relation to gender. STEMI Killip class I was more prevalent in males: 93 (86.1%) vs 12 (63.2%) cases with P = 0.01, and thrombolysis with a tendency towards the same direction: 17 (20%) vs 4 (8.3%) and P = 0.07. CONCLUSIONS: According to our results women with STEMI had significantly higher prevalence of diabetes and low school education level, as well as a higher proportion of complicated STEMI (Killip class ≥ II).
BACKGROUND: Delays in attending to ST-elevation myocardial infarction (STEMI) are indicators or markers of quality of health services. Several records suggest gender disparity in cardiac care as a contributor to the increased mortality among women. METHODS: We prospectively enrolled all consecutive STEMI patients who were transferred to our hospital from January through December 2015. The following variables were analyzed: Symptom-to-Door Time (SDT); Time to First ECG (TECG); Transfer Time to Referring Center (TTRC); and Door-to-Cath lab time (DCT). RESULTS: Of the 133 patients, 85 (63.9%) were male and 45 (36%) female. The mean age and body mass index (BMI) between the male and female genders were 56.3 and 60.5 years for the first and 26 and 27.7 Kg/M2 for the second. Diabetes and low school education level were more prevalent in women than men, with statistical significance: 20 (48.8%) vs 18 (26.1%) with P = 0.01 and 26 (54.2%) vs 28 (32.9%) with P = 0.04, respectively. Regarding the times evaluated (SDT, TECG, TTRC and DCT), there was no statistically significant difference in relation to gender. STEMI Killip class I was more prevalent in males: 93 (86.1%) vs 12 (63.2%) cases with P = 0.01, and thrombolysis with a tendency towards the same direction: 17 (20%) vs 4 (8.3%) and P = 0.07. CONCLUSIONS: According to our results women with STEMI had significantly higher prevalence of diabetes and low school education level, as well as a higher proportion of complicated STEMI (Killip class ≥ II).
Authors: Álvaro Avezum Junior; André Feldman; Antônio Carlos de Camargo Carvalho; Antônio Carlos Sobral Sousa; Antônio de Pádua Mansur; Augusto Elias Zaffalon Bozza; Breno de Alencar Araripe Falcão; Brivaldo Markman Markman Filho; Carisi Anne Polanczyk; Carlos Gun; Carlos Vicente Serrano Junior; César Cardoso de Oliveira; Dalmo Moreira; Dalton Bertolim Précoma; Daniel Magnoni; Denílson Campos de Albuquerque; Edson Renato Romano; Edson Stefanini; Elizabete Silva Dos Santos; Epotamenides Maria Good God; Expedito E Ribeiro; Fábio Sandoli de Brito; Gilson Soares Feitosa-Filho; Guilherme D'Andréa Saba Arruda; Gustavo Bernardes de Figueiredo Oliveira; Gustavo Glotz de Lima; Hans Dohman; Ieda Maria Liguori; José de Ribamar Costa Junior; José Francisco Kerr Saraiva; Lilia Nigro Maia; Luiz Felipe Pinho Moreira; Magaly Arrais dos Santos; Manoel Fernandes Canesin; Mario Sergio Soares de Azeredo Coutinho; Antônio Miguel Moretti; Nabil Ghorayeb; Núbia Welerson Vieira; Oscar Pereira Dutra; Otávio Rizzi Coelho; Paulo Ernesto Leães; Paulo Roberto Ferreira Rossi; Pedro Beraldo de Andrade; Pedro Alves Lemos Neto; Ricardo Pavanello; Ricardo Vivacqua Cardoso Costa; Roberto Bassan; Roberto Esporcatte; Roberto Miranda; Roberto Rocha Corrêa Veiga Giraldez; Rui Fernando Ramos; Stevan Krieger Martins; Vinicius Borges Cardozo Esteves; Wilson Mathias Junior Journal: Arq Bras Cardiol Date: 2015-08 Impact factor: 2.000
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Authors: Glenn N Levine; Eric R Bates; James C Blankenship; Steven R Bailey; John A Bittl; Bojan Cercek; Charles E Chambers; Stephen G Ellis; Robert A Guyton; Steven M Hollenberg; Umesh N Khot; Richard A Lange; Laura Mauri; Roxana Mehran; Issam D Moussa; Debabrata Mukherjee; Henry H Ting; Patrick T O'Gara; Frederick G Kushner; Deborah D Ascheim; Ralph G Brindis; Donald E Casey; Mina K Chung; James A de Lemos; Deborah B Diercks; James C Fang; Barry A Franklin; Christopher B Granger; Harlan M Krumholz; Jane A Linderbaum; David A Morrow; L Kristin Newby; Joseph P Ornato; Narith Ou; Martha J Radford; Jacqueline E Tamis-Holland; Carl L Tommaso; Cynthia M Tracy; Y Joseph Woo; David X Zhao; Jonathan L Halperin; Glenn N Levine; Jeffrey L Anderson; Nancy M Albert; Sana M Al-Khatib; Kim K Birtcher; Biykem Bozkurt; Ralph G Brindis; Joaquin E Cigarroa; Lesley H Curtis; Lee A Fleisher; Federico Gentile; Samuel Gidding; Mark A Hlatky; John Ikonomidis; Jose Joglar; Richard J Kovacs; E Magnus Ohman; Susan J Pressler; Frank W Sellke; Win-Kuang Shen; Duminda N Wijeysundera Journal: Catheter Cardiovasc Interv Date: 2016-05 Impact factor: 2.692