ArticleBMJ open2021
Gender-stratified analyses of symptoms associated with acute coronary syndrome in telephone triage: a cross-sectional study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Diagnostic accuracy of signs and symptoms in acute coronary syndrome and acute myocardial infarction.Scandinavian journal of primary health care · 2025Pooled it
- Difficult calls to emergency medical dispatch centres - a mixed method study.BMC emergency medicine · 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
- Diagnosing acute coronary syndrome in telephone triage: does it matter who initially calls? A cross-sectional study.BMC primary care · 2025Article
- Sex-related differences in acute coronary syndrome: insights from an observational study in a Yemeni cohort.Frontiers in cardiovascular medicine · 2025Article
- Sex Difference in 5-year Relative Survival Following Percutaneous Coronary Intervention.European cardiology · 2024Article
- Determinants of referral for suspected coronary artery disease: a qualitative study based on decision thresholds.BMC primary care · 2023Article
- Prehospital Misdiagnosed Acute Coronary Syndrome-Incidence, Discriminating Features, and Differential Diagnoses.Reviews in cardiovascular medicine · 2023Article
- Reducing Sex Disparities in STEMI Care and Outcomes: Turning the Tide for Women.Arquivos brasileiros de cardiologia · 2023Article
- Focused Chest Pain Assessment for Early Detection of Acute Coronary Syndrome: Development of a Cardiovascular Digital Health Intervention.Global heart · 2023Article
- Article
- Sex Differences in Acute Coronary Syndromes: A Global Perspective.Journal of cardiovascular development and disease · 2022Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo identify clinical variables that are associated with the diagnosis acute coronary syndrome (ACS) in women and men with chest discomfort who contact out-of-hours primary care (OHS-PC) by telephone, and to explore whether there are indications whether these variables differ among women and men.
designCross-sectional study in which we compared patient and call characteristics of triage call recordings between women with and without ACS, and men with and without ACS.
settingNine OHS-PC in the Netherlands.
participants993 women and 802 men who called OHS-PC for acute chest discomfort (pain, pressure, tightness or discomfort) between 2014 and 2016. PRIMARY OUTCOME MEASURE: Diagnosis of ACS retrieved from the patient's medical record in general practice, including hospital specialists' discharge letters.
resultsAmong 1795 patients (mean age 58.8 (SD 19.5) years, 55.3% women), 15.0% of men and 8.6% of women had an ACS. In both sexes, retrosternal chest pain was associated with ACS (women with ACS vs without 62.3% vs 40.3%, p=0.002; men with ACS vs without 52.5% vs 39.7%, p=0.032; gender interaction, p=0.323), as was pressing/heavy/tightening pain (women 78.6% vs 61.5%, p=0.011; men 82.1% vs 57.4%, p=<0.001; gender interaction, p=0.368) and radiation to the arm (women 75.6% vs 45.9%, p<0.001; men 56.0% vs 34.8%, p<0.001; gender interaction, p=0.339). Results indicate that only in women were severe pain (65.4% vs 38.1%, p=0.006; gender interaction p=0.007) and radiation to jaw (50.0% vs 22.9%, p=0.007; gender interaction p=0.015) associated with ACS.Ambulances were dispatched equally in women (72.9%) and men with ACS (70.0%).
conclusionOur results indicate there were more similarities than differences in symptoms associated with the diagnosis ACS for women and men. Important exceptions were pain severity and radiation of pain in women. Whether these differences have an impact on predicting ACS needs to be further investigated with multivariable analyses. TRIAL REGISTRATION NUMBER: NTR7331.
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