Sex differences in symptom presentation associated with acute myocardial infarction: A population-based perspective☆,☆☆,★
Section snippets
Materials and Methods
The population studied consisted of patients hospitalized with AMI (International Classification of Disease [ICD] code 410) in all 16 acute general hospitals in the Worcester, Mass., Standard Metropolitan Statistical Area (SMSA) (1990 census population = 437,000) during 1986 and 1988. Although this coronary disease surveillance system has collected incidence and mortality data over the period 1975 through 1993 on an alternating yearly basis,12, 13 data were collected only on acute symptom
Baseline characteristics
Differences in demographic, medical history, and clinical characteristics of the 810 men and 550 women hospitalized with validated AMI are shown in Table I.Empty Cell Men (n= 810) % Women ( n = 550) % p Value Age (yr) <55 20.4 6.9 55 to 64 27.3 17.3 <0.001 65 to 74 29.5 32.7 ≥75 22.8 43.1 Mean age (yr) 64.7 72.1 <0.001 Medical history Angina 24.8 29.8 <0.05 Diabetes 20.9 31.1 <0.05 Hypertension 45.5 54.1 <0.001 Stroke 8.5 8.7 NS AMI characteristics Initial AMI 68.0 69.1 NS Q-wave AMI
Discussion
The results of this multihospital population-based study suggest differences in symptom presentation in men and women hospitalized with AMI in the Worcester metropolitan area. After controlling for several demographic and clinical characteristics that could affect symptom presentation, men were significantly more likely to present to area-wide hospitals with complaints of diaphoresis while less likely to complain of nausea or back, jaw, or neck pain than women.
The strengths of this
References (31)
- et al.
Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population
Am Heart J
(1986) - et al.
Acute myocardial infarction in women: influence of sex on mortality and prognostic variables
Am J Cardiol
(1988) - et al.
Effects of sex and race on prognosis after myocardial infarction: adverse prognosis for women, particularly black women
J Am Coll Cardiol
(1987) Diagnostic testing strategies for coronary artery disease: special issues related to sex
Am J Cardiol
(1995)Sex bias in the diagnosis and treatment of coronary artery disease
Heart Lung
(1995)- et al.
A community-wide perspective of sex differences and temporal trends in the use of diagnostic and revascularization procedures for acute myocardial infarction
Am J Cardiol
(1993) - et al.
Incidence and case fatality rates of acute myocardial infarction (1975-1984): The Worcester Heart Attack Study
Am Heart J
(1988) - et al.
Sex differences and factors associated with the receipt of thrombolytic therapy in patients with acute myocardial infarction: a community-wide perspective
Am Heart J
(1996) - et al.
Utilization of emergency medical services for symptoms of acute myocardial infarction
Heart Lung
(1995) - et al.
Patient delay and receipt of thrombolytic therapy among patients with acute myocardial infarction from a community-wide perspective
Am J Cardiol
(1992)
A community-wide perspective of sex differences and temporal trends in the incidence and survival rates following acute myocardial infarction and out-of-hospital deaths due to coronary heart disease
Circulation
Prognosis in men and women coming to the emergency room with chest pain or other symptoms suggestive of acute myocardial infarction
Coron Artery Dis
Differences between women and men in survival after myocardial infarction: biology or methodology?
JAMA
In-hospital and 1-year mortality in 1524 women after myocardial infarction: comparison with 4315 men
Circulation
Women and coronary artery disease. Sex confers no immunity
Postgrad Med
Cited by (0)
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From the aDepartment of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical Center, and the bSchool of Public Health and Health Sciences, University of Massachusetts.
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Reprint requests: Robert J. Goldberg, PhD, Department of Medicine, Div. of Cardiovascular Medicine, University of Massachusetts Medical Center, 55 Lake Ave., North Worcester, MA 01655.
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