Sex differences in delay times in ST-segment elevation myocardial infarction: A cohort study

Abstract

Background: The present study analyzes a cohort of consecutive patients with ST-segment elevation acute myocardial infarction (STEMI), evaluating the ischemia-reperfusion times from the perspective of gender differences (females versus males), with a long-term follow-up.

Methods: Single-center analytical cohort study of patients with STEMI in a tertiary hospital, between January 2015 and December 2020.

Results: A total of 2668 patients were included, 2002 (75%) men and 666 (25%) women. The time elapsed from the onset of symptoms to the opening of the artery was 197min (IQR 140-300) vs 220min (IQR 152-340), p=0.004 in men and women respectively. A delay in health care significantly impacts the occurrence of cardiovascular adverse events at follow-up, HR 1.34 [95%CI 1.06-1.70]; p=0.015.

Conclusions: Women took longer to go to health care services and had a longer delay both in the diagnosis of STEMI and in coronary reperfusion. It is imperative to emphasize the necessity of educating women about the recognition of ischemic heart disease symptoms, empowering them to raise early alarms and seek timely medical attention.

Keywords: Delay; Door to balloon time; Gender bias; IAMCEST; Infarto agudo de miocardio con elevación del segmento ST; Intervención coronaria percutánea; Mujeres; Percutaneous coronary intervention; Retraso; ST-segment elevation acute myocardial infarction; STEMI; Sesgo de género; Tiempo de atención; Tiempo puerta-balón; Time-to-treatment; Women.