Comparison of Delay Times Between Symptom Onset of an Acute ST-elevation Myocardial Infarction and Hospital Arrival in Men and Women <65 Years Versus >=65 Years of Age.: Findings From the Multicenter Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) Study

摘要

A major barrier to early administration of reperfusion therapy in acute myocardial infarction (AMI) is the time that patients take to decide seeking appropriate medical care. Female sex and old age are widely acknowledged as major key factors contributing to an inadequate long prehospital delay (PHD) time. Surprisingly, it remains widely unexplored whether women per se are at a greater risk to delay longer or whether a synergistic effect of female sex in combination with older age creates the vulnerable target population at greater risk for prolonged delay. Most research to date on barriers to react adequately during AMI has been dedicated to sex differences in symptom presentation, assuming that women are more likely than men to report shortness of breath, nausea, or vomiting,5,6 which has prompted many clinicians to believe that women may report more “atypical” AMI symptoms. However, recent work failed to find discernible patterns of non-chest pain symptoms in AMI between men and women. Significantly more women than men may experience an AMI without chest pain. However, the impact of an AMI without chest pain on delay time remains questionable, and may even be in part because of a reporting bias.