Gender & Symptom Differences in Acute Coronary Syndromes

描述（由申请人提供）：心脏病是美国女性和男性最重要的公共卫生问题。糖尿病和肥胖症，这两种流行病和心脏病的主要危险因素，仅在10年内就分别增加了61%和74%。此外，自1984年以来，每年死于心血管疾病的妇女都多于男子。因此，本研究的目的是确定急性冠状动脉综合征（ACS）是否存在性别和/或症状差异，并确定在控制年龄、糖尿病、功能状态和情绪后差异是否持续。ACS包括三种临床诊断：不稳定型心绞痛、非ST段抬高型心肌梗死（MI）和ST段抬高型MI。性别的相似性和差异将被确定在每个诊断组以及ACS作为一个整体。 此外，将在三个诊断组之间进行症状比较。具体目标包括：（1）确定入院的女性和男性ACS症状的类型、严重程度、部位和质量;（2）评估住院前一周的功能状态;（3）检查住院前的焦虑和抑郁水平;（4）描述女性和男性之间的危险因素、健康史和社会人口统计学差异。这项描述性比较研究将包括约110名女性和110名男性因ACS住院的非概率样本。将对中西部四个大都市的研究中心进行抽样，以增加招募包含广泛种族和民族、收入水平和文化的异质样本的可能性。至少三分之一的样本将来自少数群体。受试者将在入院后至少12小时在其病房接受访谈。将使用急性冠状动脉综合征症状量表、加拿大心血管学会心绞痛分类工具和医院焦虑和抑郁量表收集数据。本研究的结果将为以下方面提供基础：（1）开发基于性别的ACS症状模型，该模型可传播给公众、已确诊的冠心病（CHD）患者和评估可能患有ACS的患者的从业人员;（2）开发和测试可由护理人员和分诊护士使用的ACS症状评估工具;以及（3）开发和测试干预措施，使妇女了解她们对CHD的脆弱性。

DESCRIPTION (provided by applicant): Heart disease is the foremost public health issue in the United States for both women and men. Diabetes and obesity, twin epidemics and major risk factors for heart disease, have increased 61% and 74% respectively in only 10 years. Furthermore, in every year since 1984, more women than men have died from cardiovascular disease. Therefore, the purpose of this study is to determine if there are gender and/or symptom differences in acute coronary syndromes (ACS) and to determine if differences persist after controlling for age, diabetes mellitus, functional status, and mood. ACS includes three clinical diagnoses: unstable angina, non-ST elevation myocardial infarction (MI), and ST-elevation MI. Gender similarities and differences will be identified in each diagnostic group as well as for ACS as a whole. In addition, comparison of symptoms will be made between the three diagnostic groups. Specific aims include: (1) to identify the type, severity, location, and quality of the symptoms of ACS for women and men admitted to the hospital; (2) to assess functional status in the week prior to hospitalization: (3) to examine levels of anxiety and depression prior to hospitalization; and (4) to describe risk factors, health history, and socio-demographic differences between women and men. This descriptive, comparative study will include a non-probability sample of approximately 110 women and 110 men, hospitalized with ACS. Four metropolitan midwestern sites will be sampled in order to increase the likelihood of enrolling a heterogeneous sample encompassing a broad array of racial and ethnic groups, income levels, and cultures. At least one third of the sample will come from minority groups. Subjects will be interviewed in their hospital room a minimum of 12 hours after admission. The Symptoms of Acute Coronary Syndromes Inventory, The Canadian Cardiovascular Society classification of angina tool, and the Hospital Anxiety and Depression Scale will be used to collect data. Results of this study will provide a basis for; (1) development of gender- based models of symptoms for ACS that can be disseminated to the public, those with established coronary heart disease (CHD), and to practitioners who evaluate patients with possible ACS; (2) development and testing of a Symptoms of ACS assessment tool that can be used by paramedics and triage nurses; and (3) development and testing interventions that will inform women of their vulnerability to CHD.