Gender Differences in Patients Admitted to a Certified German Chest Pain Unit: Results from the German Chest Pain Unit Registry

Settelmeier, Stephan; Rassaf, Tienush; Hochadel, Matthias; Voigtländer, Thomas; Münzel, Thomas; Senges, Jochen; Breuckmann, Frank; Giannitsis, Evangelos

doi:10.1159/000509276

Cited by 8 publications

(8 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consequently, more men underwent coronary angiography and revascularization than women. These results are not surprising as ASCVD is more prevalent in men and they are also consistent with previous studies in a CPU setting demonstrating a higher rate of angiography and PCI in men as compared with women 8,9,11 . Furthermore, women with chest pain are more likely than men to exhibit nonobstructive CAD upon angiography because of the diverse underlying pathophysiology of ischemia 13 …”

Section: Discussionsupporting

confidence: 88%

“…These results are not surprising as ASCVD is more prevalent in men and they are also consistent with previous studies in a CPU setting demonstrating a higher rate of angiography and PCI in men as compared with women. 8,9,11 Furthermore, women with chest pain are more likely than men to exhibit nonobstructive CAD upon angiography because of the diverse underlying pathophysiology of ischemia. 13 Performing a comprehensive evaluation for patients presenting with ACP provides several potential benefits for patients.…”

Section: Discussionmentioning

confidence: 99%

“…Although several studies demonstrated less noninvasive evaluation in women, other reports did not find sex-related differences in the rate of noninvasive testing during CPU evaluation 8–10 . Apparently, both women and men had a comparable risk of major adverse cardiac event (MACE) during 3–6 months’ follow-up 8,11 . Further research based on sex is important to assess the interplay of factors that shape health inequities.…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Sex differences of patients with acute chest pain evaluated through a chest pain unit

Arzuan

Iram

Matetzky

et al. 2023

Journal of Cardiovascular Medicine

View full text Add to dashboard Cite

BackgroundAlthough sex disparities between patients with acute myocardial infarction are well known, the data regarding sex differences among symptomatic patients with acute chest pain (ACP) are limited.MethodsWe retrospectively evaluated the records of 1000 consecutive patients with ACP and hospitalized in a tertiary medical center chest pain unit (CPU). Patients were divided according to sex. The primary outcome was defined as a composite end point of readmission because of chest pain, incidence of acute coronary syndrome, revascularization, and death at 90 days and 1 year.ResultsOverall, 673 men and 327 women were included in the current analysis. There was no difference in regard to sex for patients who underwent noninvasive evaluation, (87.8 vs. 87.3%, P = 0.85, for female vs. male, respectively). Among patients who underwent coronary computed tomography angiography, women were less likely to have significant coronary artery disease (CAD) (4.2 vs. 11.3%, P = 0.005). Similarly, women had fewer significant findings (4.4 vs. 7.6%, P = 0.007) on myocardial perfusion imaging. Consequently, fewer women underwent angiography (8 vs. 14%, P = 0.006) and revascularization (2.8 vs. 7.3%, P = 0.004). During follow-up, sex was not associated with the development of the primary composite outcome [odds ratio (OR) 0.91, 95% confidence interval (CI) 0.39–2.09, P-value = 0.82 and OR 1.16, 95% CI 0.65–2.06, P-value = 0.59 for 90-day and 1-year follow-up, respectively].ConclusionEvaluation of patients through a CPU enables comparable noninvasive evaluation, appropriate utilization of invasive assessment with similar outcomes during the short and intermediate follow-up period regardless of patients’ sex.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Sex differences of patients with acute chest pain evaluated through a chest pain unit

Arzuan

Iram

Matetzky

et al. 2023

Journal of Cardiovascular Medicine

View full text Add to dashboard Cite

show abstract

“…Obligatory awareness campaigns of the CPUs should therefore also address dyspnea as a possibly life-threatening symptom related or unrelated to chest pain [16]. Healthcare providers should, in line with previous findings, also pay attention to gender differences in PE symptoms [17]. Anyway, presentation of hemodynamically stable patients with dyspnea and tachycardia should point to the differential diagnosis of PE and should routinely trigger risk stratification for intermediate-low or intermediate-high risk to identify patients who might profit from thrombolysis and anticoagulation.…”

Section: Discussionmentioning

confidence: 99%

Management of Pulmonary Embolism: Results from the German Chest Pain Unit Registry

Settelmeier

Hochadel²,

Giannitsis

et al. 2021

Cardiology

Self Cite

View full text Add to dashboard Cite

Introduction: Since 2008, specialized chest pain units (CPUs) were implemented across Germany ensuring structured diagnostics in acute chest pain. This study aims to analyze the management of pulmonary embolism (PE) patients in such certified CPUs. Methods: Data were retrieved from 13,902 patients enrolled in the German CPU registry and analyzed for the diagnosis of PE including patient characteristics, critical time intervals, diagnostic workup, treatment, and prognosis. PE patients were compared to the overall CPU patient cohort. Only patients with a complete 3-month follow-up were included. Results: Overall, 1.1% of all CPU patients were diagnosed with PE. Chest pain and dyspnea were the leading symptoms. Patients with PE were older, presented with higher heart rates, and more frequently exhibited signs of heart failure, despite a normal left ventricular function. PE patients showed significantly longer time delays between symptom onset and the first medical contact, while PE patients with chest pain presented earlier than PE patients with dyspnea only. Whereas more PE patients had to be transferred to the intensive care unit, in-CPU mortality and event rates over 3 months were low. Discussion/Conclusion: This study suggests a certain risk for underdiagnosis and consecutive potential undertreatment of PE patients in German Cardiac Society (GCS)-certified CPUs, which is thought to result from an anticipated focus on patients with acute coronary syndrome (ACS). Public awareness for PE beyond chest pain should be improved. Certified CPUs should be urged to implement strategic pathways for a better simultaneous diagnostic workup of differential diagnosis beyond ACS.

show abstract

“…6,9,[11][12][13][14] Por exemplo, considerado o sexo do indivíduo, sabe-se que as mulheres com dor torácica têm, proporcionalmente, em relação aos homens, uma apresentação clínica de sintomatologia dolorosa de origem não isquêmica. 15,16 O diagnóstico diferencial, portanto, com outras doenças que causam dor simulando um infarto do miocárdio é essencial no atendimento inicial do paciente, 17 porque uma intervenção imediata e eficiente visando reperfusão do miocárdio é vital para preservação do tecido em isquemia. E não desejamos submeter indevidamente o paciente a procedimentos invasivos.…”

Section: Introductionunclassified

Fluxograma utilizado para dor torácica em 523 pacientes admitidos na emergência do Hospital Unimed Recife III

Miranda

Pontes²,

Dantas³

et al. 2021

View full text Add to dashboard Cite

Introdução A dor torácica é responsável por mais de 8 milhões de admissões por ano na emergência em hospitais nos EUA. Ainda não há um consenso sobre a melhor forma de se investigar ou tratar pacientes com dor torácica, além de ser uma área de constante aprimoramento nas diversas modalidades de como intervir naqueles pacientes onde o infarto do miocárdio é a causa da dor torácica. Recomenda-se o estabelecimento de um protocolo clínico e seu fluxograma no cuidado dos pacientes com dor torácica na emergência.Objetivo Apresentam o fluxograma utilizado no Hospital da Unimed III, Unimed Recife, Recife, Brasil, para pacientes admitidos na Unidade de Emergência com dor torácica. Com o objetivo de se avaliar dados relacionados com o uso do Protocolo Clínico de Dor Torácica usado no Hospital da Unimed Recife III, verificou-se, para o período de abril a dezembro de 2020, o número de pacientes que entraram no protocolo, quantos foram diagnosticados como infarto do miocárdio com supra ou sem supra, quantos pacientes conseguiram realizar o cateterismo em até 90 minutos e a letalidade. Uma revisão breve sobre dor torácica também foi realizada.Método Dados sobre número de pacientes que entraram no protocolo de dor torácica foi obtido do prontuário eletrônico do paciente (PEP, Business Intelligence). O período estudado foi de 1º de abril até 31 de dezembro de 2020.Resultados Foram 523 pacientes inseridos no protocolo. Dos 523 pacientes com dor torácica, 40 (7,7%) receberam o diagnóstico de infarto do miocárdio, em 19/40 (47,5%) com supra. Em 88% dos pacientes que foram submetidos a um cateterismo cardíaco o tempo porta-balão foi inferior a 90 minutos, mostrando a importância de um Protocolo Clínico na assistência de pacientes cardiológicos. Não houve morte entre os pacientes com infarto do miocárdio.Conclusão Uma parcela significativa de pacientes com dor torácica por infarto do miocárdio recebeu intervenção diagnóstica e tratamento em intervalo de tempo considerado ideal para reperfusão do tecido miocárdico com isquemia. Não houve morte.

show abstract

Gender Differences in Patients Admitted to a Certified German Chest Pain Unit: Results from the German Chest Pain Unit Registry

Cited by 8 publications

References 35 publications

Sex differences of patients with acute chest pain evaluated through a chest pain unit

Sex differences of patients with acute chest pain evaluated through a chest pain unit

Management of Pulmonary Embolism: Results from the German Chest Pain Unit Registry

Fluxograma utilizado para dor torácica em 523 pacientes admitidos na emergência do Hospital Unimed Recife III

Contact Info

Product

Resources

About