Department of Cardiology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Department of Research, Norrbotten County Council, Luleå, Sweden; Division of Nursing Sciences, Department of Medicine and Health Sciences, Linkoping University, Linköping, Sweden.
Int J Cardiol. 2018 Aug 1;264:7-11. doi: 10.1016/j.ijcard.2018.03.084. Epub 2018 Mar 24.
Symptom presentation has been sparsely studied from a gender perspective restricting the inclusion to ST elevation myocardial infarction (STEMI) patients. Correct symptom recognition is vital in order to promptly seek care in STEMI where fast reperfusion therapy is of utmost importance. Female gender has been found associated with atypical presentation in studies on mixed MI populations but it is unclear whether this is valid also in STEMI.
We assessed whether there are gender differences in symptoms and interpretation of these in STEMI, and if this is attributable to sociodemographic and clinical factors.
SymTime was a multicenter observational study including a validated questionnaire and data from medical records. Eligible STEMI patients (n = 532) were enrolled within 24 h after admittance at five Swedish hospitals.
Women were older, more often single and had lower educational level. Chest pain was less prevalent in women (74 vs 93%, p < 0.001), whereas shoulder (33 vs 15%, p < 0.001), throat/neck (34 vs 18%, p < 0.001), back pain (29 versus 12%, p < 0.001) and nausea (49 vs 29%, p < 0.001) were more prevalent. Women less often interpreted their symptoms as of cardiac origin (60 vs 69%, p = 0.04). Female gender was the strongest independent predictor of non-chest pain presentation, odds ratio 5.29, 95% confidence interval 2.85-9.80.
A striking gender difference in STEMI symptoms was found. As women significantly misinterpreted their symptoms more often, it is vital when informing about MI to the society or to high risk individuals, to highlight also other symptoms than just chest pain.
从性别角度研究症状表现的研究很少，这限制了纳入研究的仅限于 ST 段抬高型心肌梗死（STEMI）患者。在 STEMI 中，正确识别症状对于及时寻求治疗至关重要，因为快速再灌注治疗至关重要。在混合 MI 人群的研究中发现，女性性别与非典型表现相关，但在 STEMI 中是否也如此尚不清楚。
我们评估了 STEMI 中症状是否存在性别差异，以及这种差异是否归因于社会人口学和临床因素。
SymTime 是一项多中心观察性研究，包括经过验证的问卷和病历数据。在瑞典五家医院住院的 532 名符合条件的 STEMI 患者在入院后 24 小时内入组。
女性年龄更大，单身和受教育程度更低。女性胸痛发生率较低（74%比 93%，p<0.001），而肩部（33%比 15%，p<0.001）、喉咙/颈部（34%比 18%，p<0.001）、背痛（29%比 12%，p<0.001）和恶心（49%比 29%，p<0.001）更为常见。女性更倾向于将自己的症状解释为非心脏来源（60%比 69%，p=0.04）。女性性别是无胸痛表现的最强独立预测因素，优势比为 5.29，95%置信区间为 2.85-9.80。
在 STEMI 症状中发现了明显的性别差异。由于女性更频繁地错误解释自己的症状，因此在向社会或高危个体告知 MI 时，除了胸痛之外，还必须强调其他症状。
