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 beh...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2017-06, Vol.103 (11), p.863-869 |
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| creator | Khan, Nadia A Daskalopoulou, Stella S Karp, Igor Eisenberg, Mark J Pelletier, Roxanne Tsadok, Meytal Avgil Dasgupta, Kaberi Norris, Colleen M Pilote, Louise Bacon, Simon Cox, Jafna L Engert, James Ghali, William Humphries, Karin Lavoie, Kim Rabi, Doreen So, Derek Stark, Ken D Tagalakis, Vicky Thanassoulis, George Shimony, Avi Ramanthan, Krishan Kornder, Jan Anderson, Todd Norris, Colleen Graham, Michelle Natarajan, Madhu Rokoss, Mike Turek, Michele Cheema, Asim Lavi, Shahar Roth, Sherryn Huynh, Thao Nguyen, Viviane Eisenberg, Mark Methot, Julie Doucet, Michel Montigny, Martine Mansour, Samer Lauzon, Claude Cieza, Tomas Nguyen, Michel Grondin, Francois Cox, Jafna Fong, Peter Menzies, Dhananjai Rodondi, Nicolas |
| description | 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 |
| doi_str_mv | 10.1136/heartjnl-2016-309945 |
| format | Article |
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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<0.0001). Symptoms were similar between sexes and included unusual fatigue, sleep disturbances, anxiety and arm weakness/discomfort. Chest pain was less common in both sexes (24%). Women were more likely to seek care (49% vs 42%, p=0.04). Among those who sought care, women were more likely to use an ambulance for their ACS compared with men (52% vs 39%). Cardiovascular risk-reduction therapy use was low ( less than or equal to 40%) in all patients and less than half perceived their care provider suspected a cardiac source. Conclusions: Prior to ACS, women were more likely to experience prodromal symptoms and seek medical attention than men. Prehospital care was generally similar between sexes but demonstrated underutilisation of risk-reduction therapies in at-risk young adults.</description><identifier>ISSN: 1355-6037</identifier><identifier>DOI: 10.1136/heartjnl-2016-309945</identifier><language>eng</language><ispartof>Heart (British Cardiac Society), 2017-06, Vol.103 (11), p.863-869</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Khan, Nadia A</creatorcontrib><creatorcontrib>Daskalopoulou, Stella S</creatorcontrib><creatorcontrib>Karp, Igor</creatorcontrib><creatorcontrib>Eisenberg, Mark J</creatorcontrib><creatorcontrib>Pelletier, Roxanne</creatorcontrib><creatorcontrib>Tsadok, Meytal Avgil</creatorcontrib><creatorcontrib>Dasgupta, Kaberi</creatorcontrib><creatorcontrib>Norris, Colleen M</creatorcontrib><creatorcontrib>Pilote, Louise</creatorcontrib><creatorcontrib>Bacon, Simon</creatorcontrib><creatorcontrib>Cox, Jafna L</creatorcontrib><creatorcontrib>Engert, James</creatorcontrib><creatorcontrib>Ghali, William</creatorcontrib><creatorcontrib>Humphries, Karin</creatorcontrib><creatorcontrib>Lavoie, Kim</creatorcontrib><creatorcontrib>Rabi, Doreen</creatorcontrib><creatorcontrib>So, Derek</creatorcontrib><creatorcontrib>Stark, Ken D</creatorcontrib><creatorcontrib>Tagalakis, Vicky</creatorcontrib><creatorcontrib>Thanassoulis, George</creatorcontrib><creatorcontrib>Shimony, Avi</creatorcontrib><creatorcontrib>Ramanthan, Krishan</creatorcontrib><creatorcontrib>Kornder, Jan</creatorcontrib><creatorcontrib>Anderson, Todd</creatorcontrib><creatorcontrib>Norris, Colleen</creatorcontrib><creatorcontrib>Graham, Michelle</creatorcontrib><creatorcontrib>Natarajan, Madhu</creatorcontrib><creatorcontrib>Rokoss, Mike</creatorcontrib><creatorcontrib>Turek, Michele</creatorcontrib><creatorcontrib>Cheema, Asim</creatorcontrib><creatorcontrib>Lavi, Shahar</creatorcontrib><creatorcontrib>Roth, Sherryn</creatorcontrib><creatorcontrib>Huynh, Thao</creatorcontrib><creatorcontrib>Nguyen, Viviane</creatorcontrib><creatorcontrib>Eisenberg, Mark</creatorcontrib><creatorcontrib>Methot, Julie</creatorcontrib><creatorcontrib>Doucet, Michel</creatorcontrib><creatorcontrib>Montigny, Martine</creatorcontrib><creatorcontrib>Mansour, Samer</creatorcontrib><creatorcontrib>Lauzon, Claude</creatorcontrib><creatorcontrib>Cieza, Tomas</creatorcontrib><creatorcontrib>Nguyen, Michel</creatorcontrib><creatorcontrib>Grondin, Francois</creatorcontrib><creatorcontrib>Cox, Jafna</creatorcontrib><creatorcontrib>Fong, Peter</creatorcontrib><creatorcontrib>Menzies, Dhananjai</creatorcontrib><creatorcontrib>Rodondi, Nicolas</creatorcontrib><title>Sex differences in prodromal symptoms in acute coronary syndrome in patients aged 55years or younger</title><title>Heart (British Cardiac Society)</title><description>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<0.0001). Symptoms were similar between sexes and included unusual fatigue, sleep disturbances, anxiety and arm weakness/discomfort. Chest pain was less common in both sexes (24%). Women were more likely to seek care (49% vs 42%, p=0.04). Among those who sought care, women were more likely to use an ambulance for their ACS compared with men (52% vs 39%). Cardiovascular risk-reduction therapy use was low ( less than or equal to 40%) in all patients and less than half perceived their care provider suspected a cardiac source. Conclusions: Prior to ACS, women were more likely to experience prodromal symptoms and seek medical attention than men. Prehospital care was generally similar between sexes but demonstrated underutilisation of risk-reduction therapies in at-risk young adults.</description><issn>1355-6037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqVjs0OgjAQhHvQxN838LBHL2hLKcrZaLzr3TSwKKS02C2JvL1ofAFPk8x8kxnGVoJvhJDp9oHah9qaKOYijSTPskSN2FRIpaKUy92EzYhqznmS7dMpKy74gqIqS_RocySoLLTeFd412gD1TRtc83V13gWE3Hlnte-HyH4g_BZ0qNAGAn3HApTqhw8EzkPvOntHv2DjUhvC5U_nbH06Xg_naFh6dkjh1lSUozHaouvoJjIudkkc7xP5B_oGCT9Ryg</recordid><startdate>20170610</startdate><enddate>20170610</enddate><creator>Khan, Nadia A</creator><creator>Daskalopoulou, Stella S</creator><creator>Karp, Igor</creator><creator>Eisenberg, Mark J</creator><creator>Pelletier, Roxanne</creator><creator>Tsadok, Meytal Avgil</creator><creator>Dasgupta, Kaberi</creator><creator>Norris, Colleen M</creator><creator>Pilote, Louise</creator><creator>Bacon, Simon</creator><creator>Cox, Jafna L</creator><creator>Engert, James</creator><creator>Ghali, William</creator><creator>Humphries, Karin</creator><creator>Lavoie, Kim</creator><creator>Rabi, Doreen</creator><creator>So, Derek</creator><creator>Stark, Ken D</creator><creator>Tagalakis, Vicky</creator><creator>Thanassoulis, George</creator><creator>Shimony, Avi</creator><creator>Ramanthan, Krishan</creator><creator>Kornder, Jan</creator><creator>Anderson, Todd</creator><creator>Norris, Colleen</creator><creator>Graham, Michelle</creator><creator>Natarajan, Madhu</creator><creator>Rokoss, Mike</creator><creator>Turek, Michele</creator><creator>Cheema, Asim</creator><creator>Lavi, Shahar</creator><creator>Roth, Sherryn</creator><creator>Huynh, Thao</creator><creator>Nguyen, Viviane</creator><creator>Eisenberg, Mark</creator><creator>Methot, Julie</creator><creator>Doucet, Michel</creator><creator>Montigny, Martine</creator><creator>Mansour, Samer</creator><creator>Lauzon, Claude</creator><creator>Cieza, Tomas</creator><creator>Nguyen, Michel</creator><creator>Grondin, Francois</creator><creator>Cox, Jafna</creator><creator>Fong, Peter</creator><creator>Menzies, Dhananjai</creator><creator>Rodondi, Nicolas</creator><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>20170610</creationdate><title>Sex differences in prodromal symptoms in acute coronary syndrome in patients aged 55years or younger</title><author>Khan, Nadia A ; Daskalopoulou, Stella S ; Karp, Igor ; Eisenberg, Mark J ; Pelletier, Roxanne ; Tsadok, Meytal Avgil ; Dasgupta, Kaberi ; Norris, Colleen M ; Pilote, Louise ; Bacon, Simon ; Cox, Jafna L ; Engert, James ; Ghali, William ; Humphries, Karin ; Lavoie, Kim ; Rabi, Doreen ; So, Derek ; Stark, Ken D ; Tagalakis, Vicky ; Thanassoulis, George ; Shimony, Avi ; Ramanthan, Krishan ; Kornder, Jan ; Anderson, Todd ; Norris, Colleen ; Graham, Michelle ; Natarajan, Madhu ; Rokoss, Mike ; Turek, Michele ; Cheema, Asim ; Lavi, Shahar ; Roth, Sherryn ; Huynh, Thao ; Nguyen, Viviane ; Eisenberg, Mark ; Methot, Julie ; Doucet, Michel ; Montigny, Martine ; Mansour, Samer ; Lauzon, Claude ; Cieza, Tomas ; Nguyen, Michel ; Grondin, Francois ; Cox, Jafna ; Fong, Peter ; Menzies, Dhananjai ; Rodondi, Nicolas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-proquest_miscellaneous_19017422843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khan, Nadia A</creatorcontrib><creatorcontrib>Daskalopoulou, Stella S</creatorcontrib><creatorcontrib>Karp, Igor</creatorcontrib><creatorcontrib>Eisenberg, Mark J</creatorcontrib><creatorcontrib>Pelletier, Roxanne</creatorcontrib><creatorcontrib>Tsadok, Meytal Avgil</creatorcontrib><creatorcontrib>Dasgupta, Kaberi</creatorcontrib><creatorcontrib>Norris, Colleen M</creatorcontrib><creatorcontrib>Pilote, 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Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khan, Nadia A</au><au>Daskalopoulou, Stella S</au><au>Karp, Igor</au><au>Eisenberg, Mark J</au><au>Pelletier, Roxanne</au><au>Tsadok, Meytal Avgil</au><au>Dasgupta, Kaberi</au><au>Norris, Colleen M</au><au>Pilote, Louise</au><au>Bacon, Simon</au><au>Cox, Jafna L</au><au>Engert, James</au><au>Ghali, William</au><au>Humphries, Karin</au><au>Lavoie, Kim</au><au>Rabi, Doreen</au><au>So, Derek</au><au>Stark, Ken D</au><au>Tagalakis, Vicky</au><au>Thanassoulis, George</au><au>Shimony, Avi</au><au>Ramanthan, Krishan</au><au>Kornder, Jan</au><au>Anderson, Todd</au><au>Norris, Colleen</au><au>Graham, Michelle</au><au>Natarajan, Madhu</au><au>Rokoss, Mike</au><au>Turek, Michele</au><au>Cheema, Asim</au><au>Lavi, Shahar</au><au>Roth, Sherryn</au><au>Huynh, Thao</au><au>Nguyen, Viviane</au><au>Eisenberg, Mark</au><au>Methot, Julie</au><au>Doucet, Michel</au><au>Montigny, Martine</au><au>Mansour, Samer</au><au>Lauzon, Claude</au><au>Cieza, Tomas</au><au>Nguyen, Michel</au><au>Grondin, Francois</au><au>Cox, Jafna</au><au>Fong, Peter</au><au>Menzies, Dhananjai</au><au>Rodondi, Nicolas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex differences in prodromal symptoms in acute coronary syndrome in patients aged 55years or younger</atitle><jtitle>Heart (British Cardiac Society)</jtitle><date>2017-06-10</date><risdate>2017</risdate><volume>103</volume><issue>11</issue><spage>863</spage><epage>869</epage><pages>863-869</pages><issn>1355-6037</issn><abstract>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<0.0001). Symptoms were similar between sexes and included unusual fatigue, sleep disturbances, anxiety and arm weakness/discomfort. Chest pain was less common in both sexes (24%). Women were more likely to seek care (49% vs 42%, p=0.04). Among those who sought care, women were more likely to use an ambulance for their ACS compared with men (52% vs 39%). Cardiovascular risk-reduction therapy use was low ( less than or equal to 40%) in all patients and less than half perceived their care provider suspected a cardiac source. Conclusions: Prior to ACS, women were more likely to experience prodromal symptoms and seek medical attention than men. Prehospital care was generally similar between sexes but demonstrated underutilisation of risk-reduction therapies in at-risk young adults.</abstract><doi>10.1136/heartjnl-2016-309945</doi></addata></record> |
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| title | Sex differences in prodromal symptoms in acute coronary syndrome in patients aged 55years or younger |
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