Key result
Male sex shows no difference versus female sex in time to first ECG for chest pain.
Why the study?
Clinical practice guidelines recommend performing an ECG within 10 minutes for emergency department chest pain while warning about potential underdiagnosis in women, prompting an analysis of sex-based differences.
Are there sex-based differences in the care experience and outcomes of patients presenting with chest pain to an emergency department?
Cross-Sectional (n=1,469)
No
Are there sex-based differences in the care experience and outcomes of patients presenting with chest pain to an emergency department?
Absolute Event Rate: 4.18% vs 4.56%
p-value: p=0.244
This study demonstrates equitable initial emergency care for chest pain between men and women, despite men receiving more biomarker testing and having higher hospitalization rates for acute coronary syndrome.
Supports similar ECG timing by sex in ED chest pain; leaves open disparities in biomarker testing and hospitalization.
Objective: Clinical practice guidelines suggest performing an electrocardiogram (ECG) in patients with chest pain within the first 10 minutes in the emergency department, warning about subdiagnosis in women.Possible differences based on sex were analyzed.Method: An observational and retrospective study in an Emergency Department, with adult patients admitted to the Chest Pain Unit in 2021.Results: There were 1,469 patients, of whom 774 were men (52.7%).The men were younger (60 vs 65 years), were less overweight (17.18 vs 22.16%), and had more previous admissions to the Coronary Unit (12 vs 7%), compared to women.No gender differences were observed in ECG performance (91 vs 90%), ECG time (median 4.1 vs 4.5 minutes), or delay in care attention (median 25 vs 26 minutes).In terms of healthcare resources, men underwent more biomarkers: troponins (63 vs 55%; odds ratio [OR]: 1.35; 95% confidence interval [95%CI]: 1.10-1.67)and creatine phosphokinase (24.8 vs 19.1%), received more aspirin (6.7 vs 3.1%), nitrates/nitrites (6 vs 3%), and hospitalization (17.18 vs 10.50%; OR, 1.76; 95%CI; 1.30-2.40).Of 206 hospitalized, 112 had a final diagnosis of acute coronary syndrome (54%), more men than women (81 vs 31).There were no significant differences in revascularization time, medication schedule at discharge, hospital stay, or mortality.Conclusions: Gender did not affect precordial pain care, diagnosis, and treatment times, highlighting the quality of hospital care.
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Ratti et al. (2024) conducted a cross-sectional in Chest pain (n=1,469). Male sex vs. Female sex was evaluated on Time to first ECG (minutes) (p=0.244). Male sex was not associated with significant differences in the time to perform the first electrocardiogram (median 4.18 vs 4.56 minutes) compared to female sex in patients with chest pain.
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