ArticleClinical research in cardiology : official journal of the German Cardiac Society2017
Gender-specific uncertainties in the diagnosis of acute coronary syndrome.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00470587 (Advantageous Predictors of Acute Coronary Syndromes Evaluation), which is not on this map. Cited by 9 papers.
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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.
Advantageous Predictors of Acute Coronary Syndromes Evaluation (APACE) Study
Who cites it
9 citing papers in PubMed, 34 citations in OpenAlex.
- 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
- Artificial Intelligence and Its Role in the Diagnosis and Prediction of Adverse Events in Acute Coronary Syndrome: A Narrative Review of the Literature.Life (Basel, Switzerland) · 2025Review
- Determination of Age- and Sex-Specific 99th Percentile Upper Reference Limits for High-Sensitivity Cardiac Troponin I in Healthy Chinese Adults.Cardiology · 2022Article
- Gender-stratified analyses of symptoms associated with acute coronary syndrome in telephone triage: a cross-sectional study.BMJ open · 2021Article
- Conceptualizations of clinical decision-making: a scoping review in geriatric emergency medicine.BMC emergency medicine · 2020Article
- Loss of CXCR4 on non-classical monocytes in participants of the Women's Interagency HIV Study (WIHS) with subclinical atherosclerosis.Cardiovascular research · 2019Article
- Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia).BMC emergency medicine · 2018Article
- Relations of Sex to Diagnosis and Outcomes in Acute Coronary Syndrome.Journal of the American Heart Association · 2018Article
- Point-of-care testing of cardiac autonomic function for risk assessment in patients with suspected acute coronary syndromes.Clinical research in cardiology : official journal of the German Cardiac Society · 2017Article
Corrections and comments
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Authors and funding
22 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unknown whether higher rates of delayed diagnosis and misdiagnosis of acute coronary syndrome (ACS) in women might have contributed to the poorer outcome of women.
methodsIn a prospective diagnostic multicenter study, we recruited patients presenting to the emergency department (ED) with any kind of chest discomfort/chest pain with onset or peak within the last 12 h. We quantified early diagnostic uncertainty for the presence of ACS among treating physicians at the ED after 90 min, possibly responsible for delayed diagnosis, using a visual analogue scale. Late diagnostic uncertainty, possibly responsible for misdiagnosis, was defined as disagreement among two independent cardiologists' adjudication of the final diagnosis after complete work-up.
resultsAmong 2795 patients (897 women and 1898 men), ACS was the adjudicated final diagnosis in 24 % of women and 35 % of men. Early diagnostic accuracy of clinical judgment of the ED physician for ACS as quantified by the area under the receiver-operating characteristics curve was 0.89 (95 % CI 0.87-0.92) in women and 0.86 (95 % CI 0.85-0.88) in men (p = 0.046). Late diagnostic uncertainty regarding the diagnosis of ACS was 5 % in women and 7 % in men (p = 0.069).
conclusionDiagnostic uncertainty for the presence of ACS in women is not more common as compared to men and does, therefore, not explain the poorer outcome observed in women with ACS. CLINICAL
trial registrationURL: http://www.clinicaltrials.gov . Unique identifier: NCT00470587.
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