OBJECTIVE: To assess the influence of gender on the likelihood of acute myocardial infarction (AMI) among emergency department (ED) patients with symptoms suggestive of acute cardiac ischemia, and to determine whether any specific presenting signs or symptoms are associated more strongly with AMI in women than in men. DESIGN: Analysis of cohort data from a prospective clinical trial. SETTING: Emergency departments of 10 hospitals of varying sizes and types in the United States. PATIENTS: Patients 30 years of age or older (n = 10,525) who presented to the ED with chest pain or other symptoms suggestive of acute cardiac ischemia. MEASUREMENTS AND MAIN RESULTS: The prevalence of AMI was determined for men and women, and a multivariable logistic regression model predicting AMI was developed to adjust for patients' demographic and clinical characteristics. AMI was almost twice as common in men as in women (10% vs 6%). Controlling for demographics, presenting signs and symptoms, electrocardiogram features, and hospital, male gender was a significant predictor of AMI (odds ratio [OR] 1.7; 95% confidence interval [CI] 1.4, 2.0). The gender effect was eliminated, however, among patients with ST-segment elevations on electrocardiogram (OR 1.1; 95% CI 0.7, 1.7) and among patients with signs of congestive heart failure (CHF) (OR 1.1; 95% CI 0.8, 1.5). Signs of CHF were associated with AMI among women (OR 1.9; 95% CI 1.4, 2.6) but not men (OR 1.0; 95% CI 0.8, 1.3). Among patients who presented to EDs with chest pain or other symptoms suggestive of acute cardiac ischemia, AMI was more likely in men than in women. Among women with ST-segment elevation or signs of CHF, however, AMI likelihood was similar to that in men with these characteristics.
OBJECTIVE: To assess the influence of gender on the likelihood of acute myocardial infarction (AMI) among emergency department (ED) patients with symptoms suggestive of acute cardiac ischemia, and to determine whether any specific presenting signs or symptoms are associated more strongly with AMI in women than in men. DESIGN: Analysis of cohort data from a prospective clinical trial. SETTING: Emergency departments of 10 hospitals of varying sizes and types in the United States. PATIENTS: Patients 30 years of age or older (n = 10,525) who presented to the ED with chest pain or other symptoms suggestive of acute cardiac ischemia. MEASUREMENTS AND MAIN RESULTS: The prevalence of AMI was determined for men and women, and a multivariable logistic regression model predicting AMI was developed to adjust for patients' demographic and clinical characteristics. AMI was almost twice as common in men as in women (10% vs 6%). Controlling for demographics, presenting signs and symptoms, electrocardiogram features, and hospital, male gender was a significant predictor of AMI (odds ratio [OR] 1.7; 95% confidence interval [CI] 1.4, 2.0). The gender effect was eliminated, however, among patients with ST-segment elevations on electrocardiogram (OR 1.1; 95% CI 0.7, 1.7) and among patients with signs of congestive heart failure (CHF) (OR 1.1; 95% CI 0.8, 1.5). Signs of CHF were associated with AMI among women (OR 1.9; 95% CI 1.4, 2.6) but not men (OR 1.0; 95% CI 0.8, 1.3). Among patients who presented to EDs with chest pain or other symptoms suggestive of acute cardiac ischemia, AMI was more likely in men than in women. Among women with ST-segment elevation or signs of CHF, however, AMI likelihood was similar to that in men with these characteristics.
Authors: G H Tofler; P H Stone; J E Muller; S N Willich; V G Davis; W K Poole; H W Strauss; J T Willerson; A S Jaffe; T Robertson Journal: J Am Coll Cardiol Date: 1987-03 Impact factor: 24.094
Authors: W M Tierney; B J Roth; B Psaty; R McHenry; J Fitzgerald; D L Stump; F K Anderson; K W Ryder; C J McDonald; D M Smith Journal: Crit Care Med Date: 1985-07 Impact factor: 7.598
Authors: R C Becker; M Terrin; R Ross; G L Knatterud; P Desvigne-Nickens; J M Gore; E Braunwald Journal: Ann Intern Med Date: 1994-04-15 Impact factor: 25.391
Authors: Michelle M Fennessy; Anne M Fink; Ann L Eckhardt; Jessica Jones; Donna K Kruse; Kathryn J VanderZwan; Catherine J Ryan; Julie Johnson Zerwic Journal: J Cardiopulm Rehabil Prev Date: 2010 Jul-Aug Impact factor: 2.081
Authors: Mark J Ommerborn; Chad T Blackshear; DeMarc A Hickson; Michael E Griswold; Japneet Kwatra; Luc Djoussé; Cheryl R Clark Journal: Am J Prev Med Date: 2016-08-15 Impact factor: 5.043
Authors: Daniel A Duprez; David R Jacobs; Pamela L Lutsey; David Herrington; Darryl Prime; Pamela Ouyang; R Graham Barr; David A Bluemke Journal: Ethn Dis Date: 2009 Impact factor: 1.847
Authors: Carol R Regueiro; Nikita Gill; Alison Hart; Linda Crawshaw; Teresa Hentosz; Richard P Shannon Journal: J Thromb Thrombolysis Date: 2003-04 Impact factor: 2.300
Authors: Laura P Kimble; Deborah B McGuire; Sandra B Dunbar; Sharon Fazio; Anindya De; William S Weintraub; Ora S Strickland Journal: Pain Date: 2003-01 Impact factor: 6.961