2026-06-14T03:35:57Zhttps://repisalud.isciii.es/rest/oai/request
oai:repisalud.isciii.es:20.500.12105/66812024-09-27T08:05:35Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605
Repisalud author Gupta, Aakriti author Barrabés, José A author Strait, Kelly author Bueno, Hector author Porta-Sanchez, Andreu author Acosta-Velez, J. Gabriel author Lidon, Rosa-Maria author Spatz, Erica author Geda, Mary author Dreyer, Rachel P. author Lorenze, Nancy author Lichtman, Judith author D'Onofrio, Gail author Krumholz, Harlan M. funder National Institutes of Health (Estados Unidos) funder Centro Nacional de Investigaciones Cardiovasculares Carlos III (España) funder Instituto de Salud Carlos III funder Ministerio de Ciencia y Tecnología (España) 2018-11-22T08:10:52Z 2018-11-22T08:10:52Z 2018 J Am Heart Assoc. 2018; 7(6):e007021 10.1161/JAHA.117.007021 2047-9980 Journal of the American Heart Association 29514807 http://hdl.handle.net/20.500.12105/6681 Background-Young women with ST-segment-elevation myocardial infarction experience reperfusion delays more frequently than men. Our aim was to determine the electrocardiographic correlates of delay in reperfusion in young patients with ST-segment-elevation myocardial infarction. Methods and Results-We examined sex differences in initial electrocardiographic characteristics among 1359 patients with ST-segment-elevation myocardial infarction in a prospective, observational, cohort study (2008-2012) of 3501 patients with acute myocardial infarction, 18 to 55 years of age, as part of the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study at 103 US and 24 Spanish hospitals enrolling in a 2:1 ratio for women/men. We created a multivariable logistic regression model to assess the relationship between reperfusion delay (door-to-balloon time >90 or >120 minutes for transfer or door-to-needle time >30 minutes) and electrocardiographic characteristics, adjusting for sex, sociodemographic characteristics, and clinical characteristics at presentation. In our study (834 women and 525 men), women were more likely to exceed reperfusion time guidelines than men (42.4\% versus 31.5\%; P<0.01). In multivariable analyses, female sex persisted as an important factor in exceeding reperfusion guidelines after adjusting for electrocardiographic characteristics (odds ratio, 1.57; 95\% CI, 1.15-2.15). Positive voltage criteria for left ventricular hypertrophy and absence of a prehospital ECG were positive predictors of reperfusion delay; and ST elevation in lateral leads was an inverse predictor of reperfusion delay. Conclusions-Sex disparities in timeliness to reperfusion in young patients with ST-segment-elevation myocardial infarction persisted, despite adjusting for initial electrocardiographic characteristics. Left ventricular hypertrophy by voltage criteria and absence of prehospital ECG are strongly positively correlated and ST elevation in lateral leads is negatively correlated with reperfusion delay. eng Reperfusion delay Sex differences ST-segment-elevation myocardial infarction Sex Differences in Timeliness of Reperfusion in Young Patients With ST-Segment-Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics journal article URL https://repisalud.isciii.es/bitstreams/3aaace5b-fa29-4cce-a390-a871691ad2cb/download File MD5 fb98e4cd777ed9c3060f8614b7620196 261256 application/pdf SexDifferencesInTimeliness_2018.pdf URL https://repisalud.isciii.es/bitstreams/bab76723-296c-4f53-a8bf-ae4da2105a61/download File MD5 1f317f2b69ca1c82a097007c447642a9 48187 text/plain SexDifferencesInTimeliness_2018.pdf.txt