University of California, Davis Medical Center, Sacramento, CA 95817, USA.
Am Heart J. 2010 Jul;160(1):80-87.e3. doi: 10.1016/j.ahj.2010.04.017.
In 2001-2002, the American Heart Association and National Heart, Lung, and Blood Institute initiated national campaigns with the aim of increasing women's awareness of their risk of heart disease, with particular focus on women aged 40 to 60 years. Our aim is to determine if these women's awareness campaigns were associated with a reduction in the time to hospital presentation for myocardial infarction in women.
The study population comprised patients who presented with a non-ST-segment elevation myocardial infarction in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress ADverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines Registry and the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network-Get with the Guidelines registry. Analysis was done based on the introduction of the educational intervention: preintervention 2002-2003, intermediate 2004-2005, and post 2006-2007.
Of 125,161 patients, 50,162 (40.1%) are women. The median time from symptom onset to presentation was significantly longer in women than men: 3 hours (interquartile range 1.4-7.6) versus 2.8 hours (interquartile range 1.3-7.2, P < .0001), a difference that remained significant after adjusting for clinical characteristics. There was no measurable reduction in the time from symptom onset to presentation over the period of the awareness campaigns: post- versus preintervention period (-0.18%, 95% CI -3.02% to 2.74%). After adjustment for covariates, women aged 40 to 60 years had a 3.46% longer time to presentation than men (95% CI 1.06-5.92, P = .005).
There was no reduction in time from symptom onset to hospital presentation for myocardial infarction patients since national awareness campaigns in women were initiated, and a significant gender gap remains.
2001-2002 年，美国心脏协会和美国国立心肺血液研究所发起了全国性运动，旨在提高女性对心脏病风险的认识，特别是针对 40 至 60 岁的女性。我们的目的是确定这些女性意识运动是否与女性心肌梗死患者从发病到住院的时间缩短有关。
研究人群包括在非 ST 段抬高型心肌梗死患者快速危险分层以抑制不稳定型心绞痛患者不良预后的研究中出现的患者和美国心脏病学会/美国心脏协会指南实施登记研究中的国家心血管数据登记急性冠状动脉治疗和干预结局网络-与指南一致的患者。分析基于教育干预的引入进行：2002-2003 年为干预前，2004-2005 年为干预中期，2006-2007 年为干预后。
在 125161 名患者中，有 50162 名（40.1%）为女性。女性从症状发作到就诊的中位时间明显长于男性：3 小时（四分位间距 1.4-7.6）与 2.8 小时（四分位间距 1.3-7.2，P<.0001），在调整临床特征后仍存在显著差异。在意识运动期间，从症状发作到就诊的时间没有可衡量的缩短：干预后与干预前期间（-0.18%，95%置信区间-3.02%至 2.74%）。在调整协变量后，40 至 60 岁的女性就诊时间比男性长 3.46%（95%置信区间 1.06-5.92，P=.005）。
自国家发起女性意识运动以来，心肌梗死患者从发病到住院的时间没有缩短，而且性别差距仍然存在。
