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Abstract P256: Women Experience Significant Treatment Delays When Presenting with Acute Myocardial Infarction


 Aim:
 Delays in reperfusion therapy for ST-elevation myocardial infarction (STEMI) have been associated with an increased mortality. These delays are dependent upon both patient and health system factors. The objective of this study was to assess gender differences in door-to-balloon times, in patients undergoing percutaneous coronary intervention (PCI) for STEMI, with respect to its logistical components and evaluate its relationship to 30-day cardiac events (death and/or re-infarction).
 
 
 Methods:
 Clinical and logistic parameters were prospectively collected between 2005-10 for 735 STEMI patients undergoing primary PCI at two South Australian teaching hospitals. Particular attention was given to the time of patient hospital arrival to the STEMI team notification (Door-Code time), the time from STEMI notification to first balloon inflation (Code-Balloon time), and conventional Door-to-balloon time. Infarct size was estimated by extent of ST elevation on admission and peak creatine kinase levels.
 
 
 Results:
 Women were significantly older than men (66±14 vs. 60±12years, P<0.001) thus parametric variables were age-adjusted and summarized in the table below (*p < 0.05, **p<0.001 compared with men). Multivariate logistic regression analysis revealed that female gender was the strongest predictor of 30-day death and re-infarction (Odds Ratio for Female = 3.06 (95% CI = 1.45 - 6.42, p = 0.003)
 
 
 Conclusion:
 Women with STEMI undergoing primary PCI have poorer cardiac outcomes, for which a prolonged door-to-balloon time may contribute. This delay is attributable not only in the recognition of the STEMI in women (Door-to-Code time) but also in attaining mechanical reperfusion (Code-to-Balloon time). Further studies are required to identify the source of these delays.
 
 
 
