Sex Disparities in Acute Myocardial Infarction Diagnosis and Treatment.

Publication Title

The American journal of cardiology

Authors

Mary Imboden, Providence Heart Institute, Providence Saint Joseph Health, Portland, Oregon, USAFollow
Erin Koltner, Providence Heart Institute, Providence Saint Joseph Health, Portland, Oregon, USAFollow
Jane H Bryant, Providence St. Joseph Health, Providence Heart Institute, Portland, OR USAFollow
Adrienne Jones, Providence St. Joseph Health, Providence Heart Institute, Portland, OR USAFollow
Renee C Swanson, Providence St. Joseph Health, Providence Heart Institute, Portland, OR USAFollow
Lori M Tam, Providence St. Joseph Health, Providence Heart Institute, Portland, OR USAFollow
Kevin J Woolf, Providence St. Joseph Health, Providence Heart Institute, Portland, OR USAFollow

Document Type

Article

Publication Date

9-22-2025

Keywords

oregon; cards; cards publication

Abstract

This study sought to assess sex differences in timely diagnosis (time-to-ECG) and treatment (time-to-percutaneous coronary intervention (PCI)) of ST-elevation myocardial infarction (STEMI) and Non-STEMI (NSTEMI) patients utilizing a retrospective cross-sectional analysis of 1,098 STEMI (306 females and 792 males) and 2,179 NSTEMI (747 females, 1,432 males) patients that presented to 2 urban EDs between January 2022 and December 2024 was performed. Sex differences in time-to-ECG were assessed in both STEMI and NSTEMI patients, whereas differences in time-to-PCI were assessed in STEMI patients only. Time-to-ECG and time-to-PCI were compared continuously, as well as categorically (ECG delay = time-to-ECG >10 min and PCI delay = time-to-PCI >90 min or >120 min when a transfer occurred). Median time-to-ECG was 3.0 min shorter for male STEMI and NSTEMI patients. Males also had a reduced likelihood of an ECG delay (OR: 0.64 [95% CI 0.51 to 0.82]). Sex disparities remained when assessing only patients with a chief complaint of chest pain (OR:0.74 [95% CI 0.56 to 0.97]). Male STEMI patients also had a shorter wait time for PCI compared to females (walk-in: 1:26:00 vs 1:41:00, transfer: 2:19:30 vs 2:44:30, respectively). However, sex was not a significant predictor of PCI delay after controlling for time-to-ECG. In conclusion, sex disparities were found in time-to-ECG for STEMI and NSTEMI patents, as well as time-to-PCI for STEMI patients. However, sex was not significantly associated with PCI delay after controlling for time-to-ECG. This highlights the importance of timely diagnosis to ensure timely revascularization in acute myocardial infarction patients.

Area of Special Interest

Cardiovascular (Heart)

Specialty/Research Institute

Center for Cardiovascular Analytics, Research and Data Science (CARDS)

Specialty/Research Institute

Population Health

Specialty/Research Institute

Perinatology/Neonatology

DOI

10.1016/j.amjcard.2025.09.013