Abstract
IntroductionWomen with ST-elevation myocardial infarction (STEMI) present with different symptoms compared to men. This can result in delays in diagnosis and in the timely treatment of women. The aim of this study is to examine these differences, including the short- and long-term mortality in women and men.MethodsThis quality registry study included all patients with STEMI who received primary percutaneous coronary intervention in 2015 or 2016 in Amsterdam and the surrounding region.ResultsThree PCI centres and the Emergency Medical Service in Amsterdam participated. In total, 558 men (71%) and 229 women (29%) were included. Women were on average 7 years older than men (68 vs 61 years, p < 0.001), and suffered more often from hypertension (46% vs 34%, p = 0.002) and monovascular disease (69% vs 57%, p = 0.002). A higher percentage of men were current smokers (41% vs 49%, p = 0.043). Patient delay, system delay and overall ischaemic times were similar in both women and men (medians: 51, 94 and 157 min, respectively). Initiation of treatment was achieved within 90 min after STEMI diagnosis in 85% of patients (87% in women, 85% in men). Thirty-day and 1‑year mortality adjusted hazard ratio for women versus men was 1.60 (95% CI 0.9–3.0) and 1.24 (95% CI 0.8–2.0), respectively.DiscussionRecognition of cardiac complaints remains challenging for patients. In the Amsterdam region, time delays and mortality were not significantly different between men and women presenting with STEMI. These results are in contrast to findings in similar registries. This suggests that implementation of current knowledge and national campaigns are effective in increasing awareness of the signs and symptoms suggestive of myocardial infarction.
Highlights
Introduction Women withST-elevation myocardial infarction (STEMI) present with different symptoms compared to men
System delay and total ischaemic times are similar in female and male patients presenting with ST-elevated myocardial infarction (STEMI) who have received primary percutaneous coronary intervention
According to our current study this goal is achieved in 85% of all patients, meaning that STEMI management in the Amsterdam region is performing almost to the pre-set goal
Summary
Introduction Women withST-elevation myocardial infarction (STEMI) present with different symptoms compared to men. In 2004, a pre-hospital triage system was introduced in Amsterdam and the surrounding region with the aim of quickly identifying patients with ST-elevation myocardial infarction (STEMI) who are candidates for coronary reperfusion therapy. This method of diagnosis minimises pre- and in-hospital times to achieve coronary revascularisation as quickly as possible. The main goal of this study was to examine if sexbased differences exist in STEMI patients in Amsterdam and the surrounding region, focusing on patient delay, system delay and overall ischaemic time as well as all-cause mortality at 30 days and 1 year following primary percutaneous coronary intervention (pPCI)
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Schedule a callMore From: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
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