ArticleThe American journal of cardiology2023
Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction.
Article in The American journal of cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Sex differences in rural prehospital ST-segment elevation myocardial infarction care.Emergency medicine journal : EMJ · 2026Article
- Narrowing sex differences in pharmacotherapy following invasive angiography for coronary artery disease between 2017 and 2024.European heart journal open · 2026Article
- Factors associated with achieving the 10-minute scene-to-ECG transmission target in prehospital care: the role of EMS agency-level cumulative ECG transmissions.BMC emergency medicine · 2026Article
- The impact of emergency quality improvement program on the prognosis of patients with acute ST-segment elevation myocardial infarction in Taiwan.Scientific reports · 2026Article
- Persistent Sex Disparities in Pre-Hospital Delay Among Patients With STEMI Despite Overall Improvements: Findings From the Chinese Cardiovascular Association Chest Pain Center Registry.Journal of the American Heart Association · 2026Article
- Sex disparities in STEMI pathophysiology: Presentation, treatments, and outcomes.Global cardiology science & practice · 2026Review
- Myocardical Infarction in Young Adults: Revisiting Risk Factors and Atherothrombotic Pathways.Medicina (Kaunas, Lithuania) · 2025Review
- Sex differences in time to testing for pulmonary embolism in the emergency department: a survival analysis.Clinical therapeutics · 2025Article
- Sex differences in ST-segment elevation myocardial infarction patients treated by primary percutaneous intervention.Open heart · 2025Article
- Racial, Gender, and Size Bias in a Medical Graphical Abstract Gallery: A Content Analysis.Health equity · 2023Article
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Abstract
Greater symptom complexity in women than in men could slow acute ST-elevation myocardial infarction (STEMI) recognition and delay door-to-balloon (D2B) times. We sought to determine the sex differences in symptom complexity and their relation to D2B times in 1,677 young and older patients with STEMI using data from the VIRGO and SILVER-AMI studies. Symptom complexity was defined by the number of symptom patterns or phenotypes and average number of symptoms. The numbers of symptom phenotypes were compared in women and men using the Monte Carlo permutation testing. Groups were also compared using the generalized linear regression and logistic regression. The number of symptom phenotypes (244 vs 171, p = 0.02), mean number of symptoms (4.7 vs 4.2, p <0.001), and mean D2B time (114.6 vs 97.8 minutes, p = 0.004) were greater in young women than in young men but were not significantly different in older women compared with older men. The regression analysis did not show a relation between symptom complexity and D2B time overall; although, chest pain was a significant predictor of D2B times, and young women were more likely to report symptoms other than chest pain. Among patients with STEMI, 36% did not receive percutaneous coronary intervention (PCI), which was associated with presentation delay >6 hours. In patients with STEMI with either D2B time ≥90 minutes or no PCI, women had significantly more symptom phenotypes overall and in VIRGO but not in SILVER-AMI. In conclusion, the markers of symptom complexity were not associated with D2B time overall, but more symptom phenotypes in young women were associated with prolonged D2B time or no PCI. In addition, greater frequency of nonchest pain symptoms in young women may have also slowed the recognition of STEMI and D2B times in young women. Further research on symptoms clusters is needed to improve the recognition of STEMIs to improve the D2B times in young women.
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