REPERFUSION DELAYS IN WOMEN WITH STEMI

with STEMI thus a higher mortality rate in females. Aim of the study: to assess the impact of gender on decision delay and system delay reperfusion therapy with primary angioplasty (PPCI) in patients with STEMI admitted to our Department. Methods: Six hundred fifty-seven consecutive patients with STEMI referred to our hospital for PPCI were studied. 163 were female (FG) mean age 68.5, and 494 were men (MG) , mean age 62.8, p=0.0001 . For each patient demographic data, clinical variables, examinations were collected and following intervals were calculated: 1) Pain to ECG, from the symptom onset to first diagnostic ECG (pain to ECG), 2) Door To Balloon (DTB) time , from hospital arrival to the first therapy 3) the first medical contact-to-balloon time (FMCTB time), from the first diagnostic ECG to the first therapeutic intervention ;4) Total Ischemic Time (TIT), from symptom onset to reperfusion. Results: The pain to ECG was greater in FG (108 vs 87 min., p = 0.04). Female patients more frequently had an interval Pain-to-ECG over 120 minutes (41.1%) than male patients (31.1%) (p = 0.02). The DTB time, was quite comparable in both groups, (65 FG vs 63 min MG, p = 0.98,) with a similar percentage of patients with DTB ≤ 90 minutes (65% FG vs 69% MG, p = 0.3). But, the overall delay in the management of the patient presents statistically significant differences between groups (FMC in FG 100.5 vs 93 min of MG, p = 0.012) . In parallel, the proportion of patients with FMC time ≤ 120 min increased from 65% FG, to 74 % MG, p=0.02. The TIT was higher in FG compared to MG (221 vs 190 min, p = 0.004), and the percentage of patients with a TIT ≤ 120 minutes was statistically different (FG 8.1% vs 15.1%, p = 0.025). Conclusions: In our department, we demonstrated longer time to treatment in women with STEMI . Gender contributes to the pre-hospital delays to reperfusion but not to in-hospital delays . These preliminary results address the need to act on psychological factors to improve women’s perception of symptoms, and to educating physicians in order to reduce the reperfusion delays in women with STEMI.