Impact of STEMI Diagnosis and Catheterization Laboratory Activation Systems on Sex- and Age-Based Differences in Treatment Delay

Abstract

Background: Women and the elderly with ST-elevation myocardial infarction (STEMI) experience longer treatment delays despite prehospital STEMI diagnosis and catheterization laboratory activation systems. It is not known what role specific STEMI referral systems might play in mediating this gap in care. We therefore examined sexand age-based differences in STEMI treatment delay (TD) in different STEMI activation systems. Methods: This observational comparative effectiveness study comprised 3 retrospective STEMI cohorts: a traditional hospital-based R ESUM ECJC Open 3 (2021) 723e732

The Canadian Women’s Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women — Chapter 5: Sex- and Gender-Unique Manifestations of Cardiovascular Disease

“… 47 Women presenting with STEMI due to obstructive CAD experience longer door-to-balloon delays, 48 which might be improving over time. 49 Prehospital STEMI diagnosis systems, including automated systems, might attenuate this sex gap, 50 but confirmatory studies are needed. Importantly, findings from a recent single-centre study suggest that a systems-based approach to STEMI care might reduce sex disparities and improve care and outcomes in women.…”

The Canadian Women’s Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women — Chapter 6: Sex- and Gender-Specific Diagnosis and Treatment

“… 58 Protocolized diagnosis of STEMI may help reduce this observed gap, thereby improving prompt referral to cardiac catheterization for PCI in women. 59 …”

Trends in outcomes of women with myocardial infarction undergoing primary angioplasty—Analysis of randomized trials

“…Scientific and societal attention to this issue is reinforced by the growing incidence of MI in younger (ages [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] women over the last two decades due to the increased prevalence of risk factors such as diabetes and hypertension, and by the fact that the mortality from heart disease is the leading cause of death in women and is seven times higher than mortality due to breast cancer (9,10).…”