title: Are predictors for myocardial infarction the same for women and men when evaluated prior to hospital admission?
abstract: OBJECTIVE
  To describe predictors of myocardial infarction prior to hospital admission in women and men among patients with a suspected acute coronary syndrome without ST-elevation.
  
  
  METHODS
  Prospective observational study in Stockholm and Göteborg, Sweden.
  
  
  RESULTS
  Of 433 patients who did fulfill the inclusion criteria 45% were women. Fewer women (17%) than men (26%) developed acute myocardial infarction (AMI) (p=0.054), particularly among patients with initial ST-depression, in whom AMI was developed in 22% of women and 54% of men (p = 0.001). Predictors for infarct development in women were: a history of AMI and advanced age. Among men they were: initial ST-depression or a Q-wave on ECG and elevation of biochemical markers (both recorded on admission of the ambulance crew). There was a significant interaction between gender and the influence of ST-depression on the risk for development of myocardial infarction (p < 0.05).
  
  
  CONCLUSIONS
  Among patients transported with ambulance due to a suspected acute coronary syndrome and no ST-elevation fewer women than men seem to develop AMI particularly among patients with ST-depression. These results suggest that early prediction of myocardial infarction might differ between women and men with acute chest pain.
authors.affiliation: Division of Cardiology, South Hospital, Stockholm, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Svensson
authors.forename: R
authors.initials: R
authors.lastname: Nordlander
authors.forename: C
authors.initials: C
authors.lastname: Axelsson
authors.forename: J
authors.initials: J
authors.lastname: Herlitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D015986:Confounding Factors, Epidemiologic; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000628:therapy; D003625:Data Collection; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D010343:Patient Admission; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D015415:Biomarkers