Observational studyCirculation. Cardiovascular quality and outcomes2020
Sex Differences in Symptom Phenotypes Among Patients With Acute Myocardial Infarction.
Observational study in Circulation. Cardiovascular quality and outcomes, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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.
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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
27 citing papers in PubMed, 57 citations in OpenAlex.
- 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
- Reconceptualizing the ethics of diagnosis: a Foucauldian framework.Philosophy, ethics, and humanities in medicine : PEHM · 2026Article
- Cardiac point-of-care ultrasound detection of regional wall motion abnormalities optimizes clinical assessment in patients with acute myocardial infarction in the emergency department.BMC emergency medicine · 2026Article
- Symptom experience of women with ischemia and no obstructive coronary artery disease: A mixed-methods approach.American heart journal plus : cardiology research and practice · 2026Article
- Typical and atypical presentations of myocardial infarction: Symptoms and associated risk factors.Qatar medical journal · 2025Article
- Article
- Myocardial Infarction Within 30 Days of Discharge From an Emergency Department: A Descriptive Study of Albertan Women.CJC open · 2024Article
- A survey of undergraduate medical students' gender awareness and bias: the Newfoundland and Labrador perspective.Canadian medical education journal · 2024Article
- Warning symptoms associated with imminent sudden cardiac arrest: a population-based case-control study with external validation.The Lancet. Digital health · 2023Article
- miRNAs Epigenetic Tuning of Wall Remodeling in the Early Phase after Myocardial Infarction: A Novel Epidrug Approach.International journal of molecular sciences · 2023Review
- Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction.The American journal of cardiology · 2023Article
- Review
- A Survey of Female-Specific Cardiovascular Protocols in Emergency Departments in Canada.CJC open · 2023Article
- Sex differences in time to primary percutaneous coronary intervention and outcomes in patients presenting with ST-segment elevation myocardial infarction.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2022Article
- Racial Disparities in Cardiovascular Risk and Cardiovascular Care in Women.Current cardiology reports · 2022Review
- Correlation between the warning symptoms and prognosis of cardiac arrest.World journal of clinical cases · 2022Article
- Review
- Sex and Race Differences in the Evaluation and Treatment of Young Adults Presenting to the Emergency Department With Chest Pain.Journal of the American Heart Association · 2022Article
- Acute coronary syndromes.Lancet (London, England) · 2022Review
- Sex Differences in Symptom Phenotypes Among Older Patients with Acute Myocardial Infarction.The American journal of medicine · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe diagnosis of acute myocardial infarction (AMI) is missed more frequently in young women than men, which may be related to the cognitive psychology of the diagnostic process. Physicians start the diagnostic process by intuitively recognizing familiar symptom phenotypes, but little is known about how symptoms combine in individuals as unique symptom phenotypes. We examined how symptoms of AMI combine as unique symptom phenotypes in individual patients to compare the distribution of symptom phenotypes in women versus men. METHODS AND
resultsThe VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) was a multicenter, observational cohort study of 3501 young adults hospitalized with AMI. Data were collected on presenting symptoms with standardized interviews and from medical record abstraction. The number and distribution of unique symptom phenotypes were compared between women and men. Because of the 2:1 female-to-male enrollment ratio, women and men were compared with permutation testing and repeated subsampling. There were 426 interview-symptom phenotypes in women and 280 in men. The observed difference between women and men of 146 phenotypes was significant, even allowing for the greater enrollment of women (permutation
conclusionsWomen exhibited substantially more variation in unique symptom phenotypes than men, regardless of whether the symptoms were derived from structured interviews or abstracted from the medical record. These findings may provide an explanation for the higher missed diagnosis rate in young women with AMI and may have important implications for teaching and improving clinicians' ability to recognize the diagnosis of AMI in women.
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