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

A F von Eisenhart Rothe, L Albarqouni, C Gärtner, L Walz, K Smenes, K-H Ladwig

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Abstract

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 2 h, 6 h, 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 < 2 h (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.

Original languageEnglish
Pages (from-to)581-586
Number of pages6
JournalInternational Journal of Cardiology
Volume201
DOIs
Publication statusPublished - 10 Oct 2015
Externally publishedYes

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Chest Pain
Multicenter Studies
Myocardial Infarction
ST Elevation Myocardial Infarction
Logistic Models
Interviews

Cite this

@article{32ca5bc107b04b188e98141d646f01c4,
title = "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",
abstract = "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 2 h, 6 h, 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 < 2 h (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.",
author = "{von Eisenhart Rothe}, {A F} and L Albarqouni and C G{\"a}rtner and L Walz and K Smenes and K-H Ladwig",
note = "Copyright {\circledC} 2015 Elsevier Ireland Ltd. All rights reserved.",
year = "2015",
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language = "English",
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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. / von Eisenhart Rothe, A F; Albarqouni, L; Gärtner, C; Walz, L; Smenes, K; Ladwig, K-H.

In: International Journal of Cardiology, Vol. 201, 10.10.2015, p. 581-586.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Sex specific impact of prodromal chest pain on pre-hospital delay time during an acute myocardial infarction

T2 - Findings from the multicenter MEDEA Study with 619 STEMI patients

AU - von Eisenhart Rothe, A F

AU - Albarqouni, L

AU - Gärtner, C

AU - Walz, L

AU - Smenes, K

AU - Ladwig, K-H

N1 - Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

PY - 2015/10/10

Y1 - 2015/10/10

N2 - 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 2 h, 6 h, 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 < 2 h (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.

AB - 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 2 h, 6 h, 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 < 2 h (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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U2 - 10.1016/j.ijcard.2015.01.067

DO - 10.1016/j.ijcard.2015.01.067

M3 - Article

VL - 201

SP - 581

EP - 586

JO - European Journal of Cardiology

JF - European Journal of Cardiology

SN - 0167-5273

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