Women with acute myocardial infarction are more likely than men to have a delayed door-to-electrocardiogram time
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KeywordsMyocardial Infarction Emergency Department Gender Difference Chest Pain Emergency Medicine
Introduction and objective
Inhospital treatment delays experienced by women may limit their potential to achieve the maximum benefits of acute myocardial infarction (AMI) therapies. The door-to-electrocardiogram (ECG) time is recommended to be 10 minutes or less in patients with chest pain presenting to the emergency department (ED). The aim of this study was to examine gender differences in the door-to-ECG time for patients admitted to the ED with AMI.
Patients and methods
A total of 384 patients hospitalized for AMI were evaluated. Of those, 107 were female (27%) and the mean age was 67.1 ± 14.2 years. The door-to-ECG time was prospectively measured from the time of patient arrival in the ED to the time of initial ECG acquisition (minutes). Statistical analysis was performed using the chi-square test and the Fisher exact test. P < 0.05 was considered statistically significant.
The mean door-to-ECG time was 6.7 ± 12.6 minutes for men and 12.7 ± 21.8 minutes for women (P = 0.007). Women were older (72.3 ± 13.6 years vs 65.2 ± 13.9 years, P < 0.0001), had a lower prevalence of ST-elevation myocardial infarction (STEMI) (20.5% vs 79.5%, P < 0.0001) and tended to present less often chest pain on admission (47.1% vs 58.2%, P = 0.05) in comparison with men.
Women with AMI had a door-to-ECG time twice as high compared with male patients. Factors such as older age, lower prevalence of STEMI and atypical clinical presentation, more common among women in this cohort, may have contributed to the longest delay in the door-to-ECG time.