Trial reportCirculation2018
Sex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction: Evidence from the VIRGO Study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients).
Trial report in Circulation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 188 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
188 citing papers in PubMed, 7 syntheses or guidelines pooled it, 352 citations in OpenAlex.
- Sex disparities in pre-hospital delay in patients with acute myocardial infarction: a systematic review and meta-analysis.BMC cardiovascular disorders · 2026Pooled it
- Sex differences in survival following acute coronary syndrome with and without standard modifiable risk factors.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Pooled it
- Effect of HIIT on hemostasis and vascular stiffness: a systematic review and meta-analysis of randomized controlled trials.Frontiers in cardiovascular medicine · 2025Pooled it
- Sex differences in treatments and outcomes of patients with cardiogenic shock: a systematic review and epidemiological meta-analysis.Critical care (London, England) · 2024Pooled it
- The predictive value of machine learning for mortality risk in patients with acute coronary syndromes: a systematic review and meta-analysis.European journal of medical research · 2023Pooled it
- Cardiac symptom attribution and knowledge of the symptoms of acute myocardial infarction: a systematic review.BMC cardiovascular disorders · 2020Pooled it
- Sex Differences in Symptom Presentation in Acute Coronary Syndromes: A Systematic Review and Meta-analysis.Journal of the American Heart Association · 2020Pooled it
- Sex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non-ST-Segment-Elevation Myocardial Infarction in China: 2006 to 2015.Circulation. Cardiovascular quality and outcomes · 2022Trial
- Presenting Symptoms in Men and Women Diagnosed With Myocardial Infarction Using Sex-Specific Criteria.Journal of the American Heart Association · 2019Trial
- Validation of the Seattle angina questionnaire in women with ischemic heart disease.American heart journal · 2018Trial
- Clinical performance of the next generation Elecsys Troponin T high-sensitivity Gen 6 assay in acute coronary syndrome (PERFORM-TSIX): study design.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
- Absence of chest discomfort in type 1 NSTEMI patients: predictors and impact on outcome.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Sex-specific differences in the anatomical localization and severity of coronary artery disease: differential impact of conventional cardiovascular risk factors.Clinics (Sao Paulo, Brazil) · 2026Article
- Sex differences and gender-related factors in the management and perception of LDL-cholesterol in ASCVD: Real-Life evidence from the EPHESUS registry in cardiology practice.Atherosclerosis plus · 2026Article
- Clinical outcomes of invasive versus conservative strategies for very high-risk patients with non-ST-elevation acute coronary syndrome: an observational cohort study in a real-world population of China.EClinicalMedicine · 2026Article
- The Blind Spot in Cardiogenic Shock: Patients Beyond the Current Paradigm.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Differences in admission to trauma centres by sex among adults with traumatic brain injury: a population-based cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- Sex-Consistent Performance of an AI-Enabled ECG for Acute Myocardial Infarction: The ROMIAE Study.JACC. Advances · 2026Article
- Acute coronary syndromes across the lifespan of women.NPJ cardiovascular health · 2026Review
- The Mental Health-Acute Coronary Syndrome Continuum: Bidirectional Pathophysiological Links and Clinical Implications.Medical sciences (Basel, Switzerland) · 2026Review
128 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundSome studies report that women are less likely to present with chest pain for acute myocardial infarction (AMI). Information on symptom presentation, perception of symptoms, and care-seeking behaviors is limited for young patients with AMI.
methodsWe interviewed 2009 women and 976 men aged 18 to 55 years hospitalized for AMI at 103 US hospitals participating in the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients). Structured patient interviews during the index AMI hospitalization were used to collect information on symptom presentation, perception of symptoms, and care-seeking behaviors. We compared patient characteristics and presentation information by sex. Multivariable hierarchical logistic regression was used to evaluate the association between sex and symptom presentation.
resultsThe majority of women (87.0%) and men (89.5%) presented with chest pain (defined as pain, pressure, tightness, or discomfort). Women were more likely to present with ≥3 associated symptoms than men (eg, epigastric symptoms, palpitations, and pain or discomfort in the jaw, neck, arms, or between the shoulder blades; 61.9% for women versus 54.8% for men,
conclusionsThe presentation of AMI symptoms was similar for young women and men, with chest pain as the predominant symptom for both sexes. Women presented with a greater number of additional non-chest pain symptoms regardless of the presence of chest pain, and both women and their healthcare providers were less likely to attribute their prodromal symptoms to heart disease in comparison with men.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.