The Influence of Gender on Symptom Characteristics During Acute Coronary Syndrome

性别对急性冠脉综合征症状特征的影响

• 批准号: 8526843
• 负责人: HOLLI A DEVON
• 金额: $ 47.66万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-28 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8526843
• 关键词: Accident and Emergency department; Address; Admission activity; Age; American; Back Pain; Biological Markers; Cardiovascular system; Caring; Characteristics; Clinical; Cluster Analysis; Comorbidity; Data; Data Collection; Diagnosis; Diagnostic tests; Distress; Dyspepsia; Evaluation; Event; Gender; Health; Health Care Seeking Behavior; Heart Diseases; Heart failure; Hospitals; Illinois; Incidence; Inflammation; Interleukin-18; Interleukin-6; Life; Longitudinal Studies; Measures; Medical Records; Medical center; Methods; Myocardial Infarction; Myocardial Ischemia; Nausea; Oregon; Outcome; Participant; Patients; Pattern; Predictive Value; Procedures; Prospective Studies; Recording of previous events; Recruitment Activity; Reporting; Research; Risk; Risk Factors; Sampling; Sensitivity and Specificity; Severities; Sex Characteristics; Shortness of Breath; Specificity; Stratification; Stroke; Symptoms; Testing; Triage; Tumor Necrosis Factor-alpha; Unstable angina; Variant; Visit; Woman; abstracting; acute coronary syndrome; care seeking; clinically significant; design; experience; functional status; men; mortality; novel strategies; prospective

Abstract More than 1.4 million Americans are expected to experience an episode of acute coronary syndromes (ACS) in 2010. Evaluation of the symptoms of ACS is important since symptoms determine when, or if, patients seek care. Recent studies have identified gender differences in symptoms of ACS, however retrospective designs, abstraction of symptoms from medical records, and variations in assessment forms make it difficult to determine the clinical significance of gender differences or if gender specific health messages are warranted. Therefore, the aims of this prospective study are to: 1) evaluate for gender differences in the occurrence, severity, and distress of 13 ACS symptoms after adjusting for age, diagnosis, comorbidities, and functional status, 2) establish the sensitivity, specificity, and predictive value of symptoms as an indicator of ACS for women and men, 3) explore symptom clusters including characteristics of gender, age, diagnosis, comorbidities, and functional status, and 4) determine if there are gender differences in the longitudinal (30 days and 6 months) outcomes of functional status, major cardiovascular events, hospital admissions, emergency department visits, and mortality. An exploratory aim is to determine if a relationship exists between selected biomarkers and symptoms of ACS for women and men. A novel approach, in which symptoms are recorded in the emergency department as they are occurring, will be used. The sample will be comprised of 630 patients admitted to the emergency department with symptoms suggestive of ACS: 522 patients with confirmed ACS and 108 patients ruled out for ACS. Participants will be recruited from four medical centers in Illinois and Oregon. The 13-item ACS Symptom Checklist will be completed on presentation to the emergency department. Comorbidities, activity status, and patient variables will be measured when the patient is stable. Pilot data indicate that the procedures are feasible and safe. Analysis of covariance will be used to test the hypothesis that there are gender differences in symptoms. Symptom clusters will be examined using agglomerative cluster analysis, and patient outcomes will be evaluated using linear mixed methods. Findings will aid in establishing the clinical significance of ACS symptoms.

抽象的 预计将有超过 140 万美国人经历急性发作 2010 年冠状动脉综合征 (ACS)。对 ACS 症状的评估很重要 因为症状决定了患者何时或是否寻求治疗。最近的研究有 确定了 ACS 症状的性别差异，然而回顾性设计， 从病历中提取症状以及评估表的变化 使得很难确定性别差异的临床意义或性别是否 有必要提供具体的健康信息。因此，本前瞻性研究的目的 目的是： 1) 评估 13 种情况的发生、严重程度和痛苦方面的性别差异 调整年龄、诊断、合并症和功能状态后的 ACS 症状，2) 建立症状的敏感性、特异性和预测价值作为指标 女性和男性的 ACS，3) 探索症状群，包括以下特征 性别、年龄、诊断、合并症和功能状态，以及 4) 确定是否存在 是功能性纵向（30 天和 6 个月）结果的性别差异 状况、主要心血管事件、住院、急诊就诊、 和死亡率。探索性的目的是确定之间是否存在关系 为女性和男性选择 ACS 的生物标志物和症状。一种新颖的方法，在 急诊科会在出现哪些症状时将其记录下来 被使用。样本将包括 630 名急诊患者 有 ACS 症状的科室：522 名确诊 ACS 的患者 108 名患者被排除患有 ACS。参与者将从四个医疗中心招募 伊利诺伊州和俄勒冈州。包含 13 项的 ACS 症状检查表将于 向急诊科介绍。合并症、活动状态和患者 当患者稳定时将测量变量。试点数据表明 程序可行且安全。协方差分析将用于检验 假设症状存在性别差异。症状群将是 使用凝聚聚类分析进行检查，并对患者的结果进行评估 使用线性混合方法。研究结果将有助于确定其临床意义 ACS 症状。