Characteristics and outcome among women and men transported by ambulance due to symptoms arousing suspicion of acute coronary syndrome.
BACKGROUND
The purpose of this study was to describe the characteristics and outcome in relation to sex in consecutive patients who were transported by an ambulance due to symptoms arousing suspicion of acute coronary syndrome.


METHODS
Our research involved all patients transported by ambulance over a 3-month period in the community of Göteborg due to such symptoms. The P-values were age adjusted.


RESULTS
Of the 930 transported patients fulfilling the given criteria, 452 (49%) were of women. The women were older and had a lower incidence of previous acute myocardial infarction, angina pectoris, and current smoking. Women less frequently had a final diagnosis of acute coronary syndrome (22.3% vs 36.6%; p<0.0001) or acute myocardial infarction (10.1% vs 17.9%; p<0.0001). However, the mortality rate during one year was the same in women (17.2%) and men (18.7%). Women were less frequently clammy on admission to the ambulance (17% vs 30%; p<0.0001) and less frequently showed signs of myocardial ischemia in ECG upon admission to the emergency department (26% vs 38%; p<0.0001) compared to men. Among those patients with an acute coronary syndrome, women more frequently complained of dyspnea than men (27% vs 12%; p=0.018).


CONCLUSIONS
Our study suggests that among ambulance transported patients with suspicion of acute coronary syndrome there are some differences between women and men in terms of their characteristics and underlying etiology, but not in terms of the risk of mortality.
Herlitz
Johan
J
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Starke
Mia
M
Hansson
Elisabeth
E
Ringvall
Eva
E
Karlson
Björn W
BW
Waagstein
Lisbeth
L
D000208:Acute Disease; D000552:Ambulances / Q000706:statistics & numerical data*; D000787:Angina Pectoris / Q000453:epidemiology; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D002637:Chest Pain / Q000453:epidemiology* / Q000209:etiology; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009026:Mortality; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000453:epidemiology; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013546:Sweating; D013548:Sweden / Q000453:epidemiology; D013575:Syncope / Q000453:epidemiology / Q000209:etiology; D013577:Syndrome; D016896:Treatment Outcome; D014218:Triage