17 Mar Pre-Hospital Delay Influences Sex Differences in Acute Coronary Care

MedicalResearch.com Interview with:
Raffaele Bugiardini, M.D.
Professor of Cardiology
University of Bologna

Medical Research: What is the background for this study? What are the main findings?

Dr. Bugiardini: Our analysis differs from previous reports of outcomes following STEMI because prior studies have not looked at sex differences in outcomes adjusted for time from symptom onset to hospital presentation and subsequent utilization of cardiac revascularization procedures, and rates of revascularization are typically significantly lower in women compared with men

Our study is the first to look at the relationship between delays and outcomes.

Medical Research: What should clinicians and patients take away from your report?

Dr. Bugiardini: We think this is the real message behind our study it’s that it is time to look beyond the in hospital quality initiatives and, therefore, the use of door-to-balloon/needle time as the only performance measures, especially in women. It is time to recognize the limitations of door-to-balloon/needle time in women. It does not represent “time to reperfusion” We need start looking at other ways that can favorably impact women outcomes.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Bugiardini: Further investigation to identify the factors associated with this delay will provide important insights that will lead to improved care.

The total pre-hospital delay period consists of two times: time taken by patients to recognize that their symptoms are serious and to contact medical help (call to help time) and time taken from requesting help to hospital admission (home-to-hospital delay). Perhaps that home-to-hospital delay is not associated with the attribution of symptoms to a heart attack, but to a variety of symptoms when patients are women, which is namely misdiagnosis and/or medical error. This is an issue on which we need to focus more.

Citation:

The study, “Sex-Related Differences in Acute Coronary Care Among Patients with Myocardial Infarction: The Role of Pre-Hospital Delay,” will be presented on March 14, 2015 at 10 a.m. PT/1 p.m. ET/5 p.m. UTC at the American College of Cardiology’s 64^th Annual Scientific Session in San Diego.

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MedicalResearch.com Interview with: Raffaele Bugiardini, M.D. (2015). Pre-Hospital Delay Influences Sex-Differences in Acute Coronary Care 

Last Updated on June 10, 2015 by Marie Benz MD FAAD