SynthesisJournal of the American Heart Association2020
Sex Differences in Symptom Presentation in Acute Coronary Syndromes: A Systematic Review and Meta-analysis.
Synthesis in Journal of the American Heart Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 108 papers, 4 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
108 citing papers in PubMed, 4 syntheses or guidelines pooled it, 226 citations in OpenAlex.
- Educational strategies for integrating gender perspectives in health professions training: a systematic review to advance diversity, equity, and inclusion.BMC medical education · 2026Pooled 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
- Gender differences in the management and outcomes of acute coronary syndrome in indians: A systematic review and meta-analysis.Indian heart journalPooled it
- 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
- Redesigning cardiovascular medicine around sex differences.Nature medicine · 2026Review
- Seven-day mortality and its predictors among patients with acute coronary syndrome in southwestern Ethiopia: a prospective cohort study.Global cardiology science & practice · 2026Article
- Clinical Triage of Individuals With Warning Symptoms of Imminent Cardiac Arrest.Circulation. Arrhythmia and electrophysiology · 2026Observational
- Article
- Age- and Sex-Related Patterns in Coronary CT Angiography Referrals and Coronary Atherosclerotic Burden: A Single-Center Real-World Referral-Based Analysis.Medicina (Kaunas, Lithuania) · 2026Article
- Sex differences in rural prehospital ST-segment elevation myocardial infarction care.Emergency medicine journal : EMJ · 2026Article
- Investigating clinical practice variations in coronary artery disease treatment using reinforcement and transfer learning.NPJ cardiovascular health · 2026Article
- Sex-Consistent Performance of an AI-Enabled ECG for Acute Myocardial Infarction: The ROMIAE Study.JACC. Advances · 2026Article
- Heart Disease in Older Women: Unique Challenges in Diagnosis and Management.Current cardiology reports · 2026Review
- Sex-Specific Prognostic Value of Left Atrioventricular Coupling Index in Acute Coronary Syndrome: Insights From Artificial Intelligence-Enhanced 3-Dimensional Echocardiography.Journal of the American Heart Association · 2026Article
- Inside-Out Mechanism of Referred Visceral Pain: Protocol for a Systematic Review of Cutaneous Neurogenic Inflammation in Preclinical Animal Models of Visceral Diseases.JMIR research protocols · 2026Article
- Circadian troponin dynamics reveal sex-specific signals for acute coronary syndrome evaluation.Internal and emergency medicine · 2026Article
- Sex-Based Differences in Management and Outcomes of Patients Admitted or Transferred to Advanced Therapy Centers for Heart Failure.Journal of clinical medicine · 2026Article
- iCardio: Applying Business Intelligence to Assess Regional Disparity in Cardiovascular Care with Real-World Data.Arquivos brasileiros de cardiologia · 2026Article
- Article
48 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
Background Timely recognition of patients with acute coronary syndromes (ACS) is important for successful treatment. Previous research has suggested that women with ACS present with different symptoms compared with men. This review assessed the extent of sex differences in symptom presentation in patients with confirmed ACS. Methods and Results A systematic literature search was conducted in PubMed, Embase, and Cochrane up to June 2019. Two reviewers independently screened title-abstracts and full-texts according to predefined inclusion and exclusion criteria. Methodological quality was assessed using the Newcastle-Ottawa Scale. Pooled odds ratios (OR) with 95% CI of a symptom being present were calculated using aggregated and cumulative meta-analyses as well as sex-specific pooled prevalences for each symptom. Twenty-seven studies were included. Compared with men, women with ACS had higher odds of presenting with pain between the shoulder blades (OR 2.15; 95% CI, 1.95-2.37), nausea or vomiting (OR 1.64; 95% CI, 1.48-1.82) and shortness of breath (OR 1.34; 95% CI, 1.21-1.48). Women had lower odds of presenting with chest pain (OR 0.70; 95% CI, 0.63-0.78) and diaphoresis (OR 0.84; 95% CI, 0.76-0.94). Both sexes presented most often with chest pain (pooled prevalences, men 79%; 95% CI, 72-85, pooled prevalences, women 74%; 95% CI, 72-85). Other symptoms also showed substantial overlap in prevalence. The presence of sex differences has been established since the early 2000s. Newer studies did not materially change cumulative findings. Conclusions Women with ACS do have different symptoms at presentation than men with ACS, but there is also considerable overlap. Since these differences have been shown for years, symptoms should no longer be labeled as "atypical" or "typical."
Indexed as
Identifiers
What OpenQuestion holds
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.