Evaluation of gender differences in Door-to-Balloon time in ST-elevation myocardial infarction

R. P. Dreyer, J. F. Beltrame, R. Tavella, T. Air, B. Hoffmann, P. K. Pati, D. Di Fiore, M. Arstall, C. J. Zeitz

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Abstract

BACKGROUND: A delayed Door-to-Balloon (DTB) time in women with ST-elevation myocardial infarction (STEMI) has been associated with an increased mortality. The objectives of this study were to (a) quantify the components of the delayed DTB time in women and (b) assess the independent effect of gender on DTB time in patients undergoing percutaneous coronary intervention (PCI) for STEMI. METHODS: Clinical parameters were prospectively collected for 735 STEMI patients undergoing primary PCI from 2006 to 2010, with particular attention to the components of DTB time, including the onset of chest pain and the 'code' notification of the STEMI team by the Emergency Department. RESULTS: Women were significantly older with more co-morbidity. Upon hospital arrival they also experienced delays in Door-to-Code (23 vs. 17 min, P=.012), Code-to-Balloon (63 vs. 57 min, P=.001) and thus DTB time (88 vs. 72 min, P=.001). After multivariate adjustment, independent determinants of DTB time included female gender (ratio of geometric means [RGM]=1.13; 95% CI 1.02-1.26; P=.022), hypertension (RGM=1.12, 95% CI 1.02-1.23, P=.014), maximum ST-elevation (RGM=0.97, 95% CI 0.94-0.98, P
Original languageEnglish
Pages (from-to)861-869
Number of pages9
JournalHeart Lung Circ
Volume22
Issue number10
DOIs
Publication statusPublished or Issued - 2013
Externally publishedYes

Keywords

  • Aged Female *Hospitalization Humans Male Middle Aged *Myocardial Infarction/diagnosis/mortality/surgery *Percutaneous Coronary Intervention *Registries Retrospective Studies *Sex Characteristics Sex Factors Time Factors Angioplasty/balloon/coronary methods Gender bias Myocardial infarction Treatment outcome

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