title: Longer pre-hospital delays and higher mortality in women with STEMI: the e-MUST Registry.
abstract: OBJECTIVE
  The mortality rate in patients with STEMI is higher in women than in men. This higher mortality rate is partly accounted for by certain known characteristics inherent in the female population (age, diabetes). Using data from the e-MUST registry on STEMI patients in the Greater Paris area, we assessed the differences between men and women treated with reperfusion strategies.
  
  
  RESULTS
  Patients presenting within 24 hours of pain onset between 2006 and 2010 were included in the study. The male and female subpopulations were compared according to their baseline characteristics, their management delays and their early outcomes. Five thousand eight hundred and forty males (78.9%) and 1,557 females (21.1%) were included in the study. In-hospital mortality was significantly higher in women than in men, 143 (9.4%) vs. 254 (4.4%), p<0.0001, with a longer time to treatment initiation, symptoms to call (2.7±3.6 vs. 2.2±3.4 hours, p<0.0001), symptoms to first medical contact (FMC) (3.1±3.7 vs. 2.6±3.4 hours, p<0.0001), and call to FMC (25.6±23.5 vs. 23.6±18.3 min, p=0.02). After adjustment for clinical factors, severity criteria, myocardial infarction (MI) location and delays, mortality remained higher in women than in men with an odds ratio of 1.40 [1.06-1.84], p=0.017.
  
  
  CONCLUSIONS
  We demonstrated longer pre-hospital delays and higher in-hospital mortality in women. The increase in the time to treatment alone does not completely explain the persistent increase in mortality. Further studies, public awareness programmes and physician education are necessary to reduce delays and improve the prognosis of STEMI in women.
authors: Cardiology Department, European Hospital of Paris - La Roseraie, ICV-GVM, Aubervilliers, France.
authors: Hakim
authors: H
authors: Benamer
authors: Sophie
authors: S
authors: Bataille
authors: Muriel
authors: M
authors: Tafflet
authors: Patricia
authors: P
authors: Jabre
authors: François
authors: F
authors: Dupas
authors: François X
authors: FX
authors: Laborne
authors: Frédéric
authors: F
authors: Lapostolle
authors: Hugues
authors: H
authors: Lefort
authors: Jean-Michel
authors: JM
authors: Juliard
authors: Jean-Yves
authors: JY
authors: Letarnec
authors: Lionel
authors: L
authors: Lamhaut
authors: Gaelle
authors: G
authors: Lebail
authors: Thevy
authors: T
authors: Boche
authors: Aurélie
authors: A
authors: Loyeau
authors: Christophe
authors: C
authors: Caussin
authors: Mireille
authors: M
authors: Mapouata
authors: Nicole
authors: N
authors: Karam
authors: Xavie
authors: X
authors: Jouven
authors: Christian
authors: C
authors: Spaulding
authors: Yves
authors: Y
authors: Lambert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006761:Hospitals; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D012042:Registries; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000401:mortality*; D012737:Sex Factors; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors