Journal
HEART
Volume 103, Issue 11, Pages 863-869Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/heartjnl-2016-309945
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Funding
- Canadian Institutes of Health Research (CIHR)
- Heart and Stroke Foundations of Quebec, Nova Scotia
- Heart and Stroke Foundations of Quebec, Alberta
- Heart and Stroke Foundations of Quebec, Ontario
- Heart and Stroke Foundations of Quebec, Yukon
- Stroke Foundations of Quebec, British Columbia, Canada
- Michael Smith Foundation for Health Research Career Scientist award
- Fonds de recherche du Quebec (FRQS) award
- FRQS-Societequebecoised'hypertensionarterielle-Jacques de Champlain Clinician Scientist Career Award
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Background Studies suggest that young women are at highest risk for failing to recognise early symptoms of acute coronary syndrome (ACS). Objectives To examine sex differences in prodromal symptoms occurring days and weeks prior to the acute presentation of ACS. We also examined health-seeking behaviours and prehospital management in young patients. Methods Prospective cross-sectional analysis of 1145 patients (368 women) hospitalised for ACS, aged <= 55 years, from the GENdEr and Sex DetermInantS of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary SYndrome cohort study (January 2009-April 2013). Prodromal symptoms were determined using the McSweeney Acute and Prodromal Myocardial Infarction Symptom questionnaire. Healthseeking behaviour and prehospital care were determined by questionnaires. Results The median age was 49 years. The prevalence of prodromal symptoms was high and more women reported symptoms than men (85% vs 72%, p<0.0001). Symptoms were similar between sexes and included unusual fatigue, sleep disturbances, anxiety and arm weakness/discomfort. Chest pain was less common in both sexes (24%). Women were more likely to seek care (49% vs 42%, p=0.04). Among those who sought care, women were more likely to use an ambulance for their ACS compared with men (52% vs 39%). Cardiovascular risk-reduction therapy use was low (<= 40%) in all patients and less than half perceived their care provider suspected a cardiac source. Conclusions Prior to ACS, women were more likely to experience prodromal symptoms and seek medical attention than men. Prehospital care was generally similar between sexes but demonstrated underutilisation of risk-reduction therapies in at-risk young adults.
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