Delayed Care and Mortality Among Women and Men With Myocardial Infarction
Bugiardini, Raffaele (Università di Bologna)
Ricci, Beatrice (Università di Bologna)
Cenko, Edina (Università di Bologna)
Vasiljevic, Zorana (University of Belgrade)
Kedev, Sasko (University "Ss. Cyril and Methodius")
Davidovic, Goran (University in Kragujevac)
Zdravkovic, Marija (University of Belgrade)
Miličić, Davor (University of Zagreb)
Dilic, Mirza (Clinical Center University of Sarajevo)
Manfrini, Olivia (Università di Bologna)
Koller, Akos (New York Medical College)
Badimon, Lina (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Fecha:	2017
Resumen:	Women with -segment-elevation myocardial infarction () have higher mortality rates than men. We investigated whether sex-related differences in timely access to care among patients may be a factor associated with excess risk of early mortality in women. We identified 6022 patients who had information on time of symptom onset to time of hospital presentation at 41 hospitals participating in the -TC (International Survey of Acute Coronary Syndromes in Transitional Countries) registry (01218776) from October 2010 through April 2016. Patients were stratified into time-delay cohorts. We estimated the 30-day risk of all-cause mortality in each cohort. Despite similar delays in seeking care, the overall time from symptom onset to hospital presentation was longer for women than men (median: 270 minutes [range: 130-776] versus 240 minutes [range: 120-600]). After adjustment for baseline variables, female sex was independently associated with greater risk of 30-day mortality (odds ratio: 1. 58; 95% confidence interval, 1. 27-1. 97). Sex differences in mortality following STEMI were no longer observed for patients having delays from symptom onset to hospital presentation of ≤1 hour (odds ratio: 0. 77; 95% confidence interval, 0. 29-2. 02). Sex difference in mortality following persists and appears to be driven by prehospital delays in hospital presentation. Women appear to be more vulnerable to prolonged untreated ischemia. : . Unique identifier: NCT01218776.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Acute coronary syndrome ; Mortality ; Prehospital delay ; Women ; Acute Coronary Syndromes ; Coronary Artery Disease ; Mortality/Survival
Publicado en:	Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, Vol. 6 (august 2017) , ISSN 2047-9980

DOI: 10.1161/JAHA.117.005968
PMID: 28862963

26 p, 571.2 KB

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