Impact of summer season on pre-hospital time delays in women and men undergoing primary percutaneous coronary intervention

Gebhard, Caroline E.; Gebhard, Cathérine; Maafi, Foued; Bertrand, M; Stähli, Barbara E.; Marędziak, Monika; Bengs, Susan; Haider, Ahmed; Zhang, Zheng W.; Smith, David C.; Ly, Hung Q.

doi:10.1016/j.scitotenv.2018.11.363

Cited by 9 publications

(6 citation statements)

References 32 publications

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“…Previous studies have reported variability in prehospital delay according to regions and seasons. 5 , 6 We analyzed both patients with AIS and AMI in the same model with adjustments for geographical (RCCVCs) and temporal factors (year‐month of admission).…”

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confidence: 99%

Comparisons of Prehospital Delay and Related Factors Between Acute Ischemic Stroke and Acute Myocardial Infarction

Yoon

Lee

et al. 2022

JAHA

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Background Prehospital delay is an important contributor to poor outcomes in both acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We aimed to compare the prehospital delay and related factors between AIS and AMI. Methods and Results We identified patients with AIS and AMI who were admitted to the 11 Korean Regional Cardiocerebrovascular Centers via the emergency room between July 2016 and December 2018. Delayed arrival was defined as a prehospital delay of >3 hours, and the generalized linear mixed‐effects model was applied to explore the effects of potential predictors on delayed arrival. This study included 17 895 and 8322 patients with AIS and AMI, respectively. The median value of prehospital delay was 6.05 hours in AIS and 3.00 hours in AMI. The use of emergency medical services was the key determinant of delayed arrival in both groups. Previous history, 1‐person household, weekday presentation, and interhospital transfer had higher odds of delayed arrival in both groups. Age and sex had no or minimal effects on delayed arrival in AIS; however, age and female sex were associated with higher odds of delayed arrival in AMI. More severe symptoms had lower odds of delayed arrival in AIS, whereas no significant effect was observed in AMI. Off‐hour presentation had higher and prehospital awareness had lower odds of delayed arrival; however, the magnitude of their effects differed quantitatively between AIS and AMI. Conclusions The effects of some nonmodifiable and modifiable factors on prehospital delay differed between AIS and AMI. A differentiated strategy might be required to reduce prehospital delay.

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confidence: 99%

Comparisons of Prehospital Delay and Related Factors Between Acute Ischemic Stroke and Acute Myocardial Infarction

Yoon

Lee

et al. 2022

JAHA

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“…These atypicalities in clinical presentation are at the origin of the delay in the management of ACS in women. Lack of awareness of the symptoms of myocardial infarction, underestimation of the prevalence of coronary artery disease in women, and asymptomatic forms of the disease have been reported to be factors in the delay in consultation in women [18,19].…”

Section: Discussionmentioning

confidence: 99%

Inequality in The Management of Acs in Women

Fadoum¹,

Manouri²,

Deka³

et al. 2022

res. analy. jour

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Coronary artery disease is the leading cause of death in women, yet it is considered a man's disease. Management is made difficult by an often non-specific clinical presentation, delaying myocardial revascularisation. To improve the care pathway, no diagnostic strategy has been developed in the management guidelines. The aim of our study is to analyse the clinical features of coronary artery disease in Moroccan women through a retrospective study including 191 patients and to compare these data with those in the literature. The average age of the patients in our study was 62 years, and the most frequently found risk factors were menopause and hypertension. A history of coronary artery disease was present in 16.2% of patients. Chest pain was the main symptom in 91% of cases. The average admission time was 24 hours. STEMI accounted for 40% of clinical presentations and IVA was the most common coronary artery lesion. We report gender disparities in pathophysiology and clinical presentation affecting time to treatment. The longer delays in treatment found in our study may be related to a lack of awareness, a lack of resources but also to a particular social environment.

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“…La AI como presentación clínica muestra significancia estadística favoreciendo a la población femenina, de acuerdo con datos anteriores que las describen como dos tercios de las presentaciones de AI 13 . Del mismo modo, pueden ser propensas a complicaciones debido a la tendencia a retrasar la búsqueda de atención médica hasta mucho después tras la aparición de los síntomas 14 . Angiográficamente, los hombres presentan más daño multivascular que las mujeres, como se reporta en la literatura 15,16 ; en contraste, las mujeres mostraron más resultados de angiografía no patológica 16 .…”

Section: Discussionunclassified

Diferencia de presentación del síndrome coronario agudo por género en pacientes llevados al laboratorio de cateterismo en población dominicana: un estudio retrospectivo

Arias¹,

Gutiérrez

Bencosme³

et al. 2021

cysa

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Introducción: el síndrome coronario agudo (SCA) es una serie de signos y síntomas que se refieren a isquemia miocárdica repentina. Estas condiciones clínicas son Síndrome Coronario agudo sin Elevación del Segmento ST (SCASEST) y Síndrome Coronario Agudo con Elevación del Segmento ST (SCACEST). A nivel mundial hay hallazgos controversiales con respecto a la diferencia de presentación de SCA en hombres y mujeres. Objetivo: determinar las diferencias en presentación del síndrome coronario agudo según el género en República Dominicana. Métodos: en este estudio observacional retrospectivo unicéntrico, 3,548 pacientes con SCA llevados al laboratorio de cateterismo fueron observados durante el período de agosto de 2016 a septiembre de 2019. Resultados: la edad promedio de presentación fue mayor en las mujeres, con una media de 63 años (DE ± 12.2). El SCACEST fue más frecuente en hombres (69.35 %) y la Angina Inestable en mujeres (50.14 %, p <0.0001). Angiográficamente, la enfermedad coronaria multivascular fue más común en hombres y la angiografía coronaria normal en mujeres (41.30 % y 35.37 %, p <0.0001). Conclusión: dentro de la población dominicana, la mujer tiende a ser mayor al momento de presentación de SCA, con menor tendencia a someterse a intervención coronaria terapéutica.

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Impact of summer season on pre-hospital time delays in women and men undergoing primary percutaneous coronary intervention

Cited by 9 publications

References 32 publications

Comparisons of Prehospital Delay and Related Factors Between Acute Ischemic Stroke and Acute Myocardial Infarction

Comparisons of Prehospital Delay and Related Factors Between Acute Ischemic Stroke and Acute Myocardial Infarction

Inequality in The Management of Acs in Women

Diferencia de presentación del síndrome coronario agudo por género en pacientes llevados al laboratorio de cateterismo en población dominicana: un estudio retrospectivo

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