ArticleJournal of the American Heart Association2014
Sensitivity, specificity, and sex differences in symptoms reported on the 13-item acute coronary syndrome checklist.
Article in Journal of the American Heart Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Sex Differences in Symptom Presentation in Acute Coronary Syndromes: A Systematic Review and Meta-analysis.Journal of the American Heart Association · 2020Pooled it
- Pooled it
- Presenting Symptoms in Men and Women Diagnosed With Myocardial Infarction Using Sex-Specific Criteria.Journal of the American Heart Association · 2019Trial
- Article
- Clinical Triage of Individuals With Warning Symptoms of Imminent Cardiac Arrest.Circulation. Arrhythmia and electrophysiology · 2026Observational
- Article
- Patient-Reported Symptoms of Acute Coronary Syndrome in the Prehospital Period in a Prospective Study: Implications for Emergency Nurse Triage, Diagnosis, and Clinical Outcomes.Journal of emergency nursing · 2025Article
- Sex differences in chest pain presentation, triage assessment, and outcomes in urgent primary care: findings from the TRACE cohort study.Primary health care research & development · 2025Article
- Gender-stratified analyses of symptoms associated with life-threatening events in patients calling out-of-hours primary care for shortness of breath.BMC primary care · 2025Article
- Article
- Sex differences in ST-segment elevation myocardial infarction patients treated by primary percutaneous intervention.Open heart · 2025Article
- The Role of Sex and Gender in Precision Emergency Medicine: A Scoping Review and Proposed Hierarchy.Clinical therapeutics · 2024Article
- Characterizing chest pain in patients with acute coronary syndrome at Vietnam National Heart Institute: a case-control study.The Journal of international medical research · 2024Article
- Severe multivessel coronary heart disease in a young woman with familial hypercholesterolemia and congenital heart disease: A case report.Case reports in women's health · 2024Article
- Acute coronary syndrome patterns in the Young: risk factor profile and in-hospital outcomes in a tertiary referral hospital in Kenya.BMC cardiovascular disorders · 2024Article
- Warning symptoms associated with imminent sudden cardiac arrest: a population-based case-control study with external validation.The Lancet. Digital health · 2023Article
- Sex Differences in Coronary Artery Disease: Insights From the KoRean wOmen'S chest pain rEgistry (KoROSE).Korean circulation journal · 2023Review
- Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease.Diagnostics (Basel, Switzerland) · 2023Review
- Acute Chest Pain—Diagnostic Accuracy and Pre-Hospital Use of Anticoagulants and Platelet Aggregation InhibitorsDeutsches Arzteblatt international · 2023Article
- Sex Disparities in Diagnostic Evaluation and Revascularization in Patients With Acute Myocardial Infarction-A 15-Year Nationwide Study.Journal of the American Heart Association · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundClinical symptoms are part of the risk stratification approaches used in the emergency department (ED) to evaluate patients with suspected acute coronary syndromes (ACS). The objective of this study was to determine the sensitivity, specificity, and predictive value of 13 symptoms for a discharge diagnosis of ACS in women and men. METHODS AND
resultsThe sample included 736 patients admitted to 4 EDs with symptoms suggestive of ACS. Symptoms were assessed with the 13-item validated ACS Symptom Checklist. Mixed-effects logistic regression models were used to estimate sensitivity, specificity, and predictive value of each symptom for a diagnosis of ACS, adjusting for age, obesity, diabetes, and functional status. Patients were predominantly male (63%) and Caucasian (70.5%), with a mean age of 59.7±14.2 years. Chest pressure, chest discomfort, and chest pain demonstrated the highest sensitivity for ACS in both women (66%, 66%, and 67%) and men (63%, 69%, and 72%). Six symptoms were specific for a non-ACS diagnosis in both women and men. The predictive value of shoulder (odds ratio [OR]=2.53; 95% CI=1.29 to 4.96) and arm pain (OR 2.15; 95% CI=1.10 to 4.20) in women was nearly twice that of men (OR=1.11; 95% CI=0.67 to 1.85 and OR=1.21; 95% CI=0.74 to 1.99). Shortness of breath (OR=0.49; 95% CI=0.30 to 0.79) predicted a non-ACS diagnosis in men.
conclusionsThere were more similarities than differences in symptom predictors of ACS for women and men.
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