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von Eisenhart Rothe, A. ; Albarqouni, L. ; Gärtner, C.* ; Walz, L.* ; Smenes, K.R.* ; Ladwig, K.-H.

Sex specific impact of prodromal chest pain on pre-hospital delay time during an acute myocardial infarction: Findings from the multicenter MEDEA study with 619 STEMI patients.

Int. J. Cardiol. 201, 581-586 (2015)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
BACKGROUND: Scarce evidence yields conflicting results regarding the effect of prodromal chest pain (PCP) on pre-hospital delay during an acute myocardial infarction (AMI). We aimed to assess the impact of PCP on delay. METHODS: Data was collected on 619 ST-elevated MI patients from the multicenter Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study. Patients with any PCP (which was subdivided into undefined PCP, possible and definite angina) within a year before AMI were identified using the Rose questionnaire, administered in bedside interviews. The influence of PCP and its subdivisions (all compared to no PCP) was assessed using logistic regression (with cut-offs of 2h, 6h, and a 4-category ordinal outcome). RESULTS: Any type of PCP was reported by men (50.6%) more than women (34.6%) (OR=1.9; 95% CI: 1.3 to 2.8; p=.001). The median delay of patients with PCP was not significantly different to delay in patients with no PCP (p=.327). Prolonged delay times were observed in women with PCPs of lesser degree of cardiac confirmation, while the opposite was observed in men. In women, possible angina was more strongly associated with delay <2h (OR=6.8; 95% CI=2 to 23.8) than any PCP (OR=2.6; 95% CI=1.2 to 5.7). CONCLUSIONS: For men, PCPs of increasing cardiac confirmation are associated with prolonged delay. For women, PCPs of lesser cardiac confirmation are more likely to lead to prolonged delay. Future studies should investigate mediating factors.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Myocardial Infarction ; Pre-hospital Delay ; Prodromal Chest Pain ; Stemi
ISSN (print) / ISBN 0167-5273
e-ISSN 1874-1754
Journal International Journal of Cardiology
Quellenangaben Volume: 201, Issue: , Pages: 581-586 Article Number: , Supplement: ,
Publisher Elsevier
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology II (EPI2)