中国东部省份患者心肌梗死治疗决策的性别差异

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
Chaobin Lou, Tao Xu, Fangying Dong, Yangmiao Xu, Muhua Zhang, Shudong Xia, Yinchuan Xu, Chao Feng
{"title":"中国东部省份患者心肌梗死治疗决策的性别差异","authors":"Chaobin Lou, Tao Xu, Fangying Dong, Yangmiao Xu, Muhua Zhang, Shudong Xia, Yinchuan Xu, Chao Feng","doi":"10.1155/2023/8220308","DOIUrl":null,"url":null,"abstract":"<i>Background</i>. Previous studies showed that there are gender disparities in various respects of acute myocardial infarction (AMI), including risk factors, symptoms, and outcomes. However, few of them noticed the gender disparities in patients’ decision about the management of AMI, which might also be associated with the outcome. <i>Aims</i>. To identify gender disparities in patients’ decisions about the management of myocardial infarction. <i>Methods</i>. In this cohort study, the critical time points including the time of symptom onset, visiting hospital, diagnosis of AMI, consent to coronary angiography (CAG), beginning of CAG, and balloon dilation were recorded. Medication and major adverse cardiac event (MACE) within 6 months were also recorded. <i>Results</i>. Female patients took more time from symptom onset to visiting hospital (<span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 8.8423\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"></path></g></svg>),</span></span> from diagnosis of AMI to consent to CAG (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g></svg>),</span></span> and from door to needle/balloon than male (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-54\"></use></g></svg>).</span></span> Less female patients accepted CAG (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-54\"></use></g></svg>)</span></span> and coronary intervention/bypass grafting (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-54\"></use></g></svg>).</span></span> Less female patients kept good inherence to antiplatelet therapy (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-54\"></use></g></svg>)</span></span> and statins (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-54\"></use></g></svg>)</span></span> than male, more female preferred traditional Chinese medicine (TCM) than male patient (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-54\"></use></g></svg>),</span></span> and most of them had MACE within 6 months (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-54\"></use></g></svg>).</span></span> Patients’ good adherence to antiplatelet therapy and statins and accepting coronary intervention/bypass grafting were associated with a reduced risk of MACE. <i>Conclusion</i>. Female patients were more reluctant to make decisions about emergency management of AMI and tended to choose conservative treatment. More female patients preferred TCM than evidence-based medicine. Their reluctance about the critical management of AMI and poor adherence to evidence-based medicine were associated with an elevated risk of MACE.","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gender Disparities in Patients’ Decisions about the Management of Myocardial Infarction in East Chinese Province\",\"authors\":\"Chaobin Lou, Tao Xu, Fangying Dong, Yangmiao Xu, Muhua Zhang, Shudong Xia, Yinchuan Xu, Chao Feng\",\"doi\":\"10.1155/2023/8220308\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<i>Background</i>. Previous studies showed that there are gender disparities in various respects of acute myocardial infarction (AMI), including risk factors, symptoms, and outcomes. However, few of them noticed the gender disparities in patients’ decision about the management of AMI, which might also be associated with the outcome. <i>Aims</i>. To identify gender disparities in patients’ decisions about the management of myocardial infarction. <i>Methods</i>. In this cohort study, the critical time points including the time of symptom onset, visiting hospital, diagnosis of AMI, consent to coronary angiography (CAG), beginning of CAG, and balloon dilation were recorded. Medication and major adverse cardiac event (MACE) within 6 months were also recorded. <i>Results</i>. Female patients took more time from symptom onset to visiting hospital (<span><svg height=\\\"8.8423pt\\\" style=\\\"vertical-align:-0.2064009pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 8.8423\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"></path></g></svg><span></span><span><svg height=\\\"8.8423pt\\\" style=\\\"vertical-align:-0.2064009pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 28.182 8.8423\\\" width=\\\"28.182pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.605,0)\\\"></path></g></svg>),</span></span> from diagnosis of AMI to consent to CAG (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"></path></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"></path></g></svg>),</span></span> and from door to needle/balloon than male (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-54\\\"></use></g></svg>).</span></span> Less female patients accepted CAG (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-54\\\"></use></g></svg>)</span></span> and coronary intervention/bypass grafting (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-54\\\"></use></g></svg>).</span></span> Less female patients kept good inherence to antiplatelet therapy (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-54\\\"></use></g></svg>)</span></span> and statins (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-54\\\"></use></g></svg>)</span></span> than male, more female preferred traditional Chinese medicine (TCM) than male patient (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-54\\\"></use></g></svg>),</span></span> and most of them had MACE within 6 months (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-54\\\"></use></g></svg>).</span></span> Patients’ good adherence to antiplatelet therapy and statins and accepting coronary intervention/bypass grafting were associated with a reduced risk of MACE. <i>Conclusion</i>. Female patients were more reluctant to make decisions about emergency management of AMI and tended to choose conservative treatment. More female patients preferred TCM than evidence-based medicine. 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引用次数: 0

摘要

背景。既往研究表明,在急性心肌梗死(AMI)的危险因素、症状和结局等各方面存在性别差异。然而,很少有人注意到患者对AMI管理决策的性别差异,这也可能与结果有关。目标。目的:确定患者对心肌梗死处理决策的性别差异。方法。在本队列研究中,记录症状出现时间、就诊时间、AMI诊断时间、冠状动脉造影(CAG)同意时间、CAG开始时间、球囊扩张时间等关键时间点。同时记录6个月内的用药情况和主要心脏不良事件(MACE)。结果。女性患者从症状出现到就诊()、从AMI诊断到同意CAG()、从进门到针/球囊的时间均高于男性()。女性患者较少接受CAG()和冠状动脉介入/旁路移植术()。女性患者对抗血小板治疗()和他汀类药物()的良好依从性低于男性患者(),女性患者对中药()的偏好高于男性患者(),且大部分患者在6个月内发生MACE()。患者对抗血小板治疗和他汀类药物的良好依从性以及接受冠状动脉介入/旁路移植术与降低MACE风险相关。结论。女性患者对AMI的急诊处理更不愿意做出决定,倾向于选择保守治疗。女性患者更倾向于中医而非循证医学。他们对AMI关键管理的不情愿和对循证医学的不良依从性与MACE的风险升高有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Gender Disparities in Patients’ Decisions about the Management of Myocardial Infarction in East Chinese Province
Background. Previous studies showed that there are gender disparities in various respects of acute myocardial infarction (AMI), including risk factors, symptoms, and outcomes. However, few of them noticed the gender disparities in patients’ decision about the management of AMI, which might also be associated with the outcome. Aims. To identify gender disparities in patients’ decisions about the management of myocardial infarction. Methods. In this cohort study, the critical time points including the time of symptom onset, visiting hospital, diagnosis of AMI, consent to coronary angiography (CAG), beginning of CAG, and balloon dilation were recorded. Medication and major adverse cardiac event (MACE) within 6 months were also recorded. Results. Female patients took more time from symptom onset to visiting hospital (), from diagnosis of AMI to consent to CAG (), and from door to needle/balloon than male (). Less female patients accepted CAG () and coronary intervention/bypass grafting (). Less female patients kept good inherence to antiplatelet therapy () and statins () than male, more female preferred traditional Chinese medicine (TCM) than male patient (), and most of them had MACE within 6 months (). Patients’ good adherence to antiplatelet therapy and statins and accepting coronary intervention/bypass grafting were associated with a reduced risk of MACE. Conclusion. Female patients were more reluctant to make decisions about emergency management of AMI and tended to choose conservative treatment. More female patients preferred TCM than evidence-based medicine. Their reluctance about the critical management of AMI and poor adherence to evidence-based medicine were associated with an elevated risk of MACE.
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来源期刊
Emergency Medicine International
Emergency Medicine International EMERGENCY MEDICINE-
CiteScore
0.10
自引率
0.00%
发文量
187
审稿时长
17 weeks
期刊介绍: Emergency Medicine International is a peer-reviewed, Open Access journal that provides a forum for doctors, nurses, paramedics and ambulance staff. The journal publishes original research articles, review articles, and clinical studies related to prehospital care, disaster preparedness and response, acute medical and paediatric emergencies, critical care, sports medicine, wound care, and toxicology.
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