Clinical InvestigationAcute Ischemic Heart DiseaseGender differences in time to presentation for myocardial infarction before and after a national women's cardiovascular awareness campaign: A temporal analysis from the Can Rapid Risk Stratification of Unstable Angina Patients Suppress ADverse Outcomes with Early Implementation (CRUSADE) and the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network–Get with the Guidelines (NCDR ACTION Registry–GWTG)
Section snippets
Population
The Can Rapid Risk Stratification of Unstable Angina Patients Suppress ADverse Outcomes with Early Implementation of the American College of Cardiology/AHA Guidelines (CRUSADE) quality improvement initiative included patients with ischemic symptoms at rest within 24 hours of presentation and high-risk features (ST-segment depression, transient ST-segment elevation, and/or positive cardiac biomarkers). The National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes
Results
The overall study comprised 125,161 patients with 50,162 (40%) women and 74,999 (60%) men. The median age of the overall cohort was 69 years (IQR 57-79). The overall cohort was predominantly white. (Table I). In addition, 24% of the patients presented with signs of heart failure; and 31% had ST depression on their presenting electrocardiogram (Table I).
The cohort included pooled data from 2 distinct registries. When comparing patients from the ACTION-GWTG (16,017 patients) and CRUSADE registry
Discussion
In this contemporary cohort of patients with NSTEMI evaluated during the AHA's “Go Red for Women” and the NHLBI's “Heart Truth” campaigns., we noted no change in time to presentation in men or women over the 6-year period. Both of these campaigns focused on increasing awareness of cardiovascular risk and not specifically on improving time to presentation. However, given the significant resources expended on patient education, our findings regarding the lack of change in time to presentation
Conclusion
Despite evidence that current educational efforts have significantly increased awareness of the risk factors associated with heart disease, we did not find a decrease in time from symptom onset to presentation in patients with NSTEMI. Future studies should focus on identifying the best mechanism of emphasizing the need for early action once symptoms concerning for a cardiac event are recognized.
Disclosures
Presented in abstract form at the American Heart Association, New Orleans, LA, November 2008.
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