Comparison of the Management of Non-ST Segment Elevation Myocardial Infarction During Emergency Care According to Sex of the Patient

The atypical characteristics of acute coronary syndrome in women lead to differences in management and treatment. We investigated these differences in the urgent management of non-ST-segment acute myocardial infarction (NSTEMI). Data on 39 variables were collected from 539 patients with NSTEMI treated at 97 Spanish emergency departments. After adjustment for 10 baseline differences, the only significant differences were that time-to-arrival at the emergency department was longer for women (odds ratio [OR] = 0.52; 95% confidence interval [CI], 0.28-0.95) and that they received more clopidogrel (OR = 1.65; 95% CI, 1.06-2.56). The trend to fewer admissions to coronary or intensive care units (42.9% vs 55.6%) and fewer catheterization procedures (29.7% vs 40.7%) disappeared after adjustment. We conclude that there are virtually no differences in treatment in women with N-STEMI in prehospital and emergency care. (C) 2011 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L. All rights reserved.