Coronary disease & ACS

Reducing gap in pre-hospital delay between women and men presenting with ST-elevation myocardial infarction

Eur J Prev CardiolPublished Registry-based cohort study

Authors' conclusion

Over two decades, delay between symptom onset and hospital admission in STEMI decreased significantly for men and women. The decline was more pronounced in women, leading to the sex gap disappearing in the adjusted analysis for 2019.

Study context

Population
Patients admitted for ST-elevation myocardial infarction (STEMI) in Switzerland, AMIS Plus registry, 2002–201974.5% men
Participants
15,350 patients
Exposure
Women vs men
Outcome
Pre-hospital delay (symptom onset to hospital admission) over time by sex
Methodological detailsmultivariable quantile regression
  • Multivariable quantile regression

Main finding

As reported in the abstract

Pre-hospital delay (symptom onset to hospital admission), 2002–2019
GroupValueAdjusted change in delay
Menmedian 150 (IQR 84–345) min−1.6 min per year
Womenmedian 180 (IQR 100–414) min−3.3 min per year

Value

Menmedian 150 (IQR 84–345) min
Womenmedian 180 (IQR 100–414) min

Adjusted change in delay

Men−1.6 min per year
Women−3.3 min per year
Unadjusted sex difference in delay, 2002
60 min (P = 0.0042)
Unadjusted sex difference in delay, 2019
40.5 min (P = 0.165)
Interaction between sex and admission year (multivariable model); decrease stronger for women
P = 0.038
Adjusted difference between men and women, 2002
26.93 min
Adjusted difference between men and women, 2019
−1.97 min for women

Observational data: associations, not effects.

Original publication

Reducing gap in pre-hospital delay between women and men presenting with ST-elevation myocardial infarction. Eur J Prev Cardiol. Published 13 December 2022. doi:10.1093/eurjpc/zwac294

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