Characteristics and outcome among women and men transported by ambulance due to symptoms arousing suspicion of acute coronary syndrome.
Johan Herlitz, Mia Starke, Elisabeth Hansson, Eva Ringvall, Björn W Karlson, Lisbeth Waagstein
Med Sci Monit 2002; 8(4): CR251-256
BACKGROUND: The purpose of this study was to describe the characteristicsand outcome in relation to sex in consecutive patients who were transported by an ambulance due to symptomsarousing suspicion of acute coronary syndrome. MATERIAL/METHODS: Our research involved all patients transportedby ambulance over a 3-month period in the community of Göteborg due to such symptoms. The P-values wereage adjusted. RESULTS: Of the 930 transported patients fulfilling the given criteria, 452 (49%) wereof women. The women were older and had a lower incidence of previous acute myocardial infarction, anginapectoris, and current smoking. Women less frequently had a final diagnosis of acute coronary syndrome(22.3% vs 36.6% p<0.0001) or acute myocardial infarction (10.1% vs 17.9%;p<0.0001). However, the mortality rate during one year was the same in women (17.2%) and men (18.7%). Women were less frequently clammy on admission to the ambulance (17% vs 30%; p<0.0001) and less frequently showed signs of myocardial ischemia in ECG upon admission to the emergency department (26% vs 38%; p<0.0001) compared to men. Among those patients with an acute coronary syndrome, women more frequently complained of dyspnea than men (27% vs 12%; p=0.018).
Conclusion: Our study suggests that among ambulance transported patients with suspicion of acute coronary syndrome there are some differences between women and men in terms of their characteristics
and underlying etiology, but not in terms of the risk of mortality.
Keywords: Acute Disease, Ambulances, Angina Pectoris, Arrhythmia, Chest Pain, Coronary Disease, Dyspnea, Electrocardiography, Female, Follow-Up Studies, Humans, Incidence, Male, Mortality, Myocardial Infarction, Myocardial Ischemia, Prognosis, Recurrence, Retrospective Studies, Sex Factors, Smoking, Sweating, Sweden, Syncope, Syndrome, Treatment Outcome, Triage