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Published on: December 9, 2013
Differences in clinical characteristics in patients with first ST-segment elevation myocardial infarction and
Reza Jabbari1, Charlotte Glinge2, Bjarke Risgaard2
1Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, 9441, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark. rezajabbari77@gmail.com.
Insights
Women with ST-elevation myocardial infarction (STEMI) and ventricular fibrillation (VF) present later and have different risk factors than men. Emphasizing prompt medical attention for angina in women, particularly those with lower socioeconomic status, is crucial.
Area of Science:
- Cardiology
- Medical Research
- Public Health
Background:
- ST-elevation myocardial infarction (STEMI) is a critical cardiac event.
- Ventricular fibrillation (VF) is a life-threatening complication of STEMI.
- Understanding sex differences in STEMI with VF is vital for targeted interventions.
Purpose of the Study:
- To investigate sex-based disparities in clinical characteristics, arrest circumstances, and procedural aspects of STEMI patients experiencing ventricular fibrillation (VF) before angioplasty.
- To identify specific factors contributing to these sex differences.
Main Methods:
- Analysis of 329 STEMI patients with VF from the prospective GEVAMI case-control study in Denmark.
- Comparison of clinical characteristics, arrest circumstances, and procedural data between 276 men and 53 women.
- Multivariable logistic regression to identify factors associated with female sex.
Main Results:
- Women experienced longer symptom-to-angioplasty intervals and later VF presentation during transport.
- Women had lower income, lower education, higher smoking rates, and higher prevalence of depression and prior angina.
- Low education, low income, and history of angina were significantly associated with female sex; no procedural differences were found.
Conclusions:
- Significant sex differences exist in the clinical presentation and circumstances surrounding VF in STEMI patients.
- Women, especially those with lower socioeconomic status, may delay seeking care for angina symptoms.
- Targeted awareness campaigns emphasizing the urgency of medical attention for angina in women are warranted.
Purpose:
We aimed to assess sex differences in clinical characteristics, circumstances of arrest, and procedural characteristics in ST-elevation myocardial infarction (STEMI) patients with ventricular fibrillation (VF) prior to angioplasty.
Methods:
Cases of VF with first STEMI (n = 329; 276 men and 53 women) were identified from the GEVAMI study, which is prospectively assembled case-control study among first STEMI patients in Denmark.
Results:
Compared to men, women experienced symptoms for a longer time interval prior to angioplasty (140 vs. 166 min, p = 0.020), and were more likely to present with VF later during transport to the hospital rather than prior to emergency medical services arrival (36 vs. 52%, p = 0.040). Prior to VF, women had a significantly lower income (p = 0.002) and education level (p = 0.008), were less likely to consume alcohol (3 vs. 6 units, p = 0.040), more likely to smoke (71 vs. 52%, p = 0.007), and more likely to have depression (25 vs. 10%, p = 0.002) or a history of angina (59 vs. 42%, p = 0.030). Even though women had more angina within a year prior to VF, no difference was observed in self-reported contact with the healthcare system (p = 0.200). In multivariable logistic regression models, history of angina (OR = 2.70; p = 0.006), low educational level (OR = 2.80, p = 0.012) and low income (OR = 6.00, p = 0.005) remained significantly associated with female sex. There were no differences in procedural characteristics between men and women.
Conclusions:
We found several sex differences in clinical characteristics and circumstances of arrest. The importance of seeking acute medical attention when experiencing angina should be emphasized in women, especially in women with low socioeconomic status.
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