title: Gender differences in calls to 9-1-1 during an acute coronary syndrome.
abstract: Calling 911 during acute coronary syndromes (ACS) decreases time to treatment and may improve prognosis. Women may have more atypical ACS symptoms compared to men, but few data are available on differences in gender and ACS symptoms in calling 911. In this study, patient interviews and structured chart reviews were conducted to determine gender differences in calling 911. Calls to 911 were assessed by self-report and validated by medical chart review. Of the 476 patients studied, 292 (61%) were diagnosed with unstable angina and 184 (39%) with myocardial infarctions (MIs). Overall, only 23% of patients called 911. Similar percentages of women and men with unstable angina called 911 (15% and 13%, respectively, p = 0.59). In contrast, women with MIs were significantly more likely to call 911 than men (57% vs 28%, p <0.001). After adjustment for sociodemographic factors, health insurance status, history of MI, the left ventricular ejection fraction, Global Registry of Acute Coronary Events (GRACE) score, and ACS symptoms, women were 1.79 times more likely to call 911 during an MI than men (prevalence ratio 1.79, 95% confidence interval 1.22 to 2.64, p <0.01). In conclusion, the findings of the present study suggest that initiatives to increase calls to 911 are needed for women and men.
authors.affiliation: Center for Cardiovascular Behavioral Health, Columbia University Medical Center, New York, NY, USA.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Newman
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
authors.forename: Siqin
authors.initials: S
authors.lastname: Ye
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Shaffer
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000368:Aged; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology