Evidence map›Paper›PMID 41744109›Full record

ArticleJournal of the American Heart Association2026

Persistent Sex Disparities in Pre-Hospital Delay Among Patients With STEMI Despite Overall Improvements: Findings From the Chinese Cardiovascular Association Chest Pain Center Registry.

Zhenzhen Lu, Tongtong Zang, Hao Li, Yiling Liu, Li Shen, Lihong Huang

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Journal of the American Heart Association · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Zhenzhen LuDepartment of Biostatistics, Zhongshan Hospital Fudan University Shanghai China.ORCID 0000-0002-7490-2512
Tongtong ZangDepartment of Cardiology, Zhongshan Hospital Fudan University, Shanghai Institute of Cardiovascular Diseases Shanghai China.ORCID 0000-0002-6176-1503
Hao LiDepartment of Biostatistics, Zhongshan Hospital Fudan University Shanghai China.
Yiling LiuSchool of Science China Pharmaceutical University Nanjing China.
Li ShenDepartment of Cardiology, Zhongshan Hospital Fudan University, Shanghai Institute of Cardiovascular Diseases Shanghai China.ORCID 0000-0002-6105-1202
Lihong HuangDepartment of Biostatistics, Zhongshan Hospital Fudan University Shanghai China.ORCID 0000-0002-6701-7822

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWomen with ST-segment-elevation myocardial infarction (STEMI) historically experience longer pre-hospital delays than men. Whether this disparity has narrowed in China remains unknown.

methodsWe analyzed STEMI patients in the Chinese Cardiovascular Association Database-Chest Pain Center (2016-2023). Total pre-hospital delay and its components were analyzed using multivariable quantile regression across three periods (2016-2019; 2020-2022; 2023), adjusting for age, comorbidities, and cardiovascular risk factors.

resultsAmong 1 104 812 patients, 162 032 (14.7%) were transported by emergency medical services (EMS). Women had consistently longer pre-hospital delays than men (median: 170 versus 124 minutes); the adjusted sex difference at median was 24.44 minutes (95% CI: 22.71-26.16), widening at higher percentiles. Overall delays declined from 2016 to 2019 to 2023, with attenuation during 2020 to 2022. The sex disparities persisted and were most pronounced in patients <80 years and appeared larger in rural settings. In the EMS-transported subgroup, the adjusted median difference was 15.69 minutes (95% CI: 13.24-18.13). Breakdown of delay components indicated that the disparity was driven by EMS call delay (adjusted median difference 13.95 minutes, 95% CI: 11.23-16.67) rather than transportation delay.

conclusionsDespite overall improvements, sex disparities in pre-hospital delay persisted in China, largely arose before EMS activation. Targeted strategies should prioritize symptom recognition and early EMS activation among women, with rural-tailored implementation.

Indexed as

Emergency Medical ServicesHealthcare DisparitiesST Elevation Myocardial InfarctionTime-to-TreatmentAgedAged, 80 and overChinaEast Asian PeopleFemaleHumansMaleMiddle AgedRegistriesSex FactorsTime FactorsTreatment Delayemergency medical servicespre‐hospital delaysex disparitiesST‐elevation myocardial infarction

Identifiers

PMID41744109
PMCPMC13055712

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Registered trials

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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.