What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute coronary syndrome (n=249). Intervention: Female gender vs. Male gender. Primary outcome: Median prehospital delay time (PDT) (p=0.001).

May 13, 2014

Gender Differences in Factors Associated With Prehospital Delay Among Acute Coronary Syndrome Patients in Pakistan

Key Result

Women with acute coronary syndrome had a significantly longer median prehospital delay time compared to men (7 hours vs 3.5 hours, p=0.001), driven by different social and individual factors.

Study Design

Type

Cross-Sectional (n=249)

Multicenter

Yes

Structured PICO

Are there gender differences in prehospital delay time and associated factors among acute coronary syndrome patients?

Population

249 acute coronary syndrome (ACS) patients at two tertiary care hospitals in a large metropolitan city of Pakistan

Outcome

Prehospital delay time (PDT) and its associated factors

Women with acute coronary syndrome in Pakistan experience significantly longer prehospital delays than men, driven by different psychosocial and economic factors, highlighting the need for gender-specific educational interventions.

Main Result

Absolute Event Rate: 7% vs 3.5%

p-value: p=0.001

Abstract

PURPOSE: To identify gender differences in prehospital delay time (PDT) and its associated factors among acute coronary syndrome (ACS) patients. DESIGN: Descriptive cross-sectional comparative study. METHODS: This study was conducted among 249 ACS patients at two tertiary care hospitals of a large metropolitan city of Pakistan. Data were collected through the modified Response to Symptoms Questionnaire. RESULTS: The median PDT of women was found to be 7 hours, compared to 3.5 hours among men (p = .001). Results of the regression analysis indicated that most women delayed because of social factors, such as attendants' responses to their symptoms (p = .002), and because they were worried about expenses required for the treatment (p = .002); yet, most men delayed owing to individual factors, such as waiting for symptoms to subside (p< .001), and not recognizing the symptoms as being cardiac related (p< .001). Having anxiety and lack of knowledge about symptoms was associated with extended PDT among both genders. CONCLUSION: Women delayed longer than men in seeking treatment for their ACS symptoms. Different factors were associated with PDT in women and men. This study may provide important insights for designing interventional studies to reduce PDT in Pakistani ACS patients.

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