Sex differences in prodromal symptoms in acute coronary syndrome in patients aged 55years or younger

Background: Studies suggest that young women are at highest risk for failing to recognise early symptoms of acute coronary syndrome (ACS). Objectives: To examine sex differences in prodromal symptoms occurring days and weeks prior to the acute presentation of ACS. We also examined health-seeking behaviours and prehospital management in young patients.MethodsProspective cross-sectional analysis of 1145 patients (368 women) hospitalised for ACS, aged less than or equal to 55years, from the GENdEr and Sex DetermInantS of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary SYndrome cohort study (January 2009-April 2013). Prodromal symptoms were determined using the McSweeney Acute and Prodromal Myocardial Infarction Symptom questionnaire. Health-seeking behaviour and prehospital care were determined by questionnaires. Results: The median age was 49years. The prevalence of prodromal symptoms was high and more women reported symptoms than men (85% vs 72%, p