Abstract 4993: Time from Symptom Onset to Hospital Presentation in Women with Myocardial Infarction: A Temporal Analysis from the CRUSADE and NCDR ACTION Registry
Background: In 2002 the National Heart Lung and Blood institute initiated The Heart Truth program, an education program focused on women age 40 – 60 years old with the aim of increasing women’s awareness of their risk of heart disease. In addition, the Go Red for Women campaign was introduced by the American Heart Association in 2004 to increase awareness of cardiovascular disease. The dramatic increase in the awareness of heart disease from 2000 to 2006 in women has been attributed in part to these programs. We assessed whether there was a reduction in the time from symptom onset to hospital presentation in women who had a myocardial infarction over a similar time period.
Methods: The study population comprised 206,430 patients from 661 sites who presented with a non ST elevation myocardial infarction (NSTEMI) in the CRUSADE QI Registry from January 1, 2002 to December 31, 2006 and the NCDR ACTION Registry from January 1, 2007 to December 31, 2007. Patients were excluded if they were transfer-in patients (43,236), were missing symptom onset time or had extreme symptom onset times (37,700) or lacked documented sex (333).
Results: Of the 125,161 eligible patients, the study cohort comprised 50,162 women, predominantly Caucasian (78.7%) with a median age of 74 years (IQR 61,83). Of these women 36.4% had diabetes, 76.4% had hypertension, 27.8% prior myocardial infarction, and 27.7% had a prior coronary revascularization.. In women the median time from symptom onset to presentation was similar from 2002 through 2007 (p-value trend=0.8366). The overall median time to presentation in women was 3.0 hrs (IQR 1.4, 7.6) and in men 2.8 hrs (IQR 1.3, 7.2) p<0.001.
Conclusion: Despite significant national efforts to improve awareness of cardiovascular disease and time to presentation in women with chest pain, we noted no improvement in time from symptom onset to hospital presentation from 2002 to 2007 in a large sample of women with NSTEMI included in the CRUSADE and ACTION NCDR national registries.