title: Time trends in symptoms and prehospital delay time in women vs. men with myocardial infarction over a 15-year period. The Northern Sweden MONICA Study.
abstract: BACKGROUND
  Few studies have examined the time between onset of myocardial infarction (MI) symptoms and arrival at hospital (prehospital delay time) and symptoms in men vs. women.
  
  
  OBJECTIVE
  To describe prehospital delay time and symptoms in men vs. women with MI and to analyse trends over time and according to age.
  
  
  METHODS
  The Northern Sweden MONICA myocardial infarction registry, 1989-2003, included 5,072 men and 1,470 women with a confirmed MI.
  
  
  RESULTS
  Typical pain was present in 86% of the men and 81% of the women. The proportion with typical symptoms decreased over time for men and increased for women. Typical symptoms were more common among younger persons than older persons. Insufficiently reported symptoms was unchanged in men over time and decreased among women. Up to the age of 65, no gender differences were seen in the prehospital delay. In the oldest age group (65-74 years) time to hospital was longer than among the younger groups, especially among women.
  
  
  CONCLUSIONS
  There were no major gender differences in prehospital delay or type of symptoms. However, over time the proportion with typical symptoms decreased in men and increased in women. Older patients had longer prehospital delay and less typical symptoms.
authors.affiliation: The Northern Sweden MONICA myocardial registry, Department of Research, Norrbotten County Council, 971 89 Luleå, Sweden. rose-marie.isaksson@nll.se
authors.forename: Rose-Marie
authors.initials: RM
authors.lastname: Isaksson
authors.forename: Lars
authors.initials: L
authors.lastname: Holmgren
authors.forename: Dan
authors.initials: D
authors.lastname: Lundblad
authors.forename: Christine
authors.initials: C
authors.lastname: Brulin
authors.forename: Mats
authors.initials: M
authors.lastname: Eliasson
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D002637:Chest Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008571:Men / Q000523:psychology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D015404:Nursing Methodology Research; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011159:Population Surveillance; D012042:Registries; D012727:Sex Characteristics; D017678:Sex Distribution; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014930:Women / Q000523:psychology*