Sex Differences in Symptom Presentation in Acute Coronary Syndromes: A Systematic Review and Meta-analysis

Autor: Michiel L. Bots, Roos E. M. van Oosterhout, Angela H.E.M. Maas, Frans H. Rutten, Annemarijn R. de Boer, Sanne A.E. Peters
Rok vydání: 2020
Předmět:
Male
sex differences
Acute coronary syndrome
medicine.medical_specialty
Nausea
diagnosis
Epidemiology
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
030204 cardiovascular system & hematology
Chest pain
Risk Assessment
Odds
acute coronary syndrome
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
Sex Factors
systematic review
Predictive Value of Tests
Risk Factors
Internal medicine
medicine
Prevalence
Humans
Women
030212 general & internal medicine
Aged
business.industry
Systematic Review and Meta‐analysis
Odds ratio
Health Status Disparities
Middle Aged
medicine.disease
Prognosis
meta‐analysis
Meta-analysis
Inclusion and exclusion criteria
Vomiting
symptoms
Female
medicine.symptom
Symptom Assessment
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 9
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 9, 9
ISSN: 2047-9980
Popis: Background Timely recognition of patients with acute coronary syndromes ( ACS ) is important for successful treatment. Previous research has suggested that women with ACS present with different symptoms compared with men. This review assessed the extent of sex differences in symptom presentation in patients with confirmed ACS . Methods and Results A systematic literature search was conducted in PubMed, Embase, and Cochrane up to June 2019. Two reviewers independently screened title‐abstracts and full‐texts according to predefined inclusion and exclusion criteria. Methodological quality was assessed using the Newcastle‐Ottawa Scale. Pooled odds ratios ( OR ) with 95% CI of a symptom being present were calculated using aggregated and cumulative meta‐analyses as well as sex‐specific pooled prevalences for each symptom. Twenty‐seven studies were included. Compared with men, women with ACS had higher odds of presenting with pain between the shoulder blades ( OR 2.15; 95% CI , 1.95–2.37), nausea or vomiting ( OR 1.64; 95% CI , 1.48–1.82) and shortness of breath ( OR 1.34; 95% CI , 1.21–1.48). Women had lower odds of presenting with chest pain ( OR 0.70; 95% CI , 0.63–0.78) and diaphoresis (OR 0.84; 95% CI , 0.76–0.94). Both sexes presented most often with chest pain (pooled prevalences, men 79%; 95% CI , 72–85, pooled prevalences, women 74%; 95% CI , 72–85). Other symptoms also showed substantial overlap in prevalence. The presence of sex differences has been established since the early 2000s. Newer studies did not materially change cumulative findings. Conclusions Women with ACS do have different symptoms at presentation than men with ACS , but there is also considerable overlap. Since these differences have been shown for years, symptoms should no longer be labeled as “atypical” or “typical.”
Databáze: OpenAIRE
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