Abstract 15615: Gender Differences in Door-to-Balloon Times in Contemporary Clinical Practice: Is Medicine's Yentl Syndrome Still Alive?
Introduction: Timely reperfusion (door-to-balloon time <90 minutes) with primary percutaneous coronary intervention (PPCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) is the standard-of-care benchmark for revascularization in acute STEMI.
Objective: We investigated whether gender differences exist in the current era in the universally accepted and reproducible metric of “timely reperfusion,” i.e. door-to-balloon (D2B) time.
Methods: A total of 908 consecutive patients with STEMI [31% females (n=283), median age 61 years] presented within 12 hours of symptom onset during the study period (Jan. 1, 2002 to June 30, 2009). Using a precise cardiac catheterization protocol, all STEMI patients underwent PPCI. D2B times were compared during both regular hours (weekdays 7:30 AM-7:30 PM) and off hours (weekends, holidays and 7:30 PM-7:30 AM weeknights).
Results: Women were older than men (median age 69 vs. 59 years p<0.001), more often hypertensive (64% vs. 51% p<0.001) and diabetic (29.7% vs. 18.9% p<0.001), and had more previous history of heart failure (7.4% vs. 1.9% p<0.001). Median D2B time was higher in women compared to men (70 min vs. 64 min; p=0.006) and only 66% of women were revascularized under the guideline-recommended D2B time of <90 min compared with 74% of men; p<0.001. This discrepancy was higher during off hours compared to regular hours (Figure).
Conclusions: More women than men experience delay in primary percutaneous revascularization for acute STEMI.
- © 2010 by American Heart Association, Inc.