Gender & Symptom Differences in Acute Coronary Syndromes

描述(申请人提供)：心脏病是美国最重要的公共卫生问题，无论是对女性还是男性。糖尿病和肥胖症这对双胞胎流行病和心脏病的主要危险因素在短短10年内分别增长了61%和74%。此外，自1984年以来，每年死于心血管疾病的女性比男性多。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，并确定在控制了年龄、糖尿病、功能状态和情绪后，差异是否持续存在。急性冠脉综合征包括三种临床诊断：不稳定型心绞痛、非ST段抬高型心肌梗死和ST段抬高型心肌梗死。将在每个诊断组以及作为一个整体的ACS中确定性别的相似和不同。此外，还将对三个诊断组的症状进行比较。具体目标包括：(1)确定入院的女性和男性的ACS症状的类型、严重程度、位置和质量；(2)在住院前一周评估功能状况：(3)在住院前检查焦虑和抑郁的水平；(4)描述男女之间的危险因素、健康史和社会人口统计学差异。这项描述性的比较研究将包括大约110名女性和110名男性的非概率样本，他们因急性冠脉综合征住院。将对四个中西部大都市进行抽样，以增加纳入涵盖广泛种族和民族、收入水平和文化的不同样本的可能性。至少三分之一的样本将来自少数族裔群体。受试者将在入院后至少12小时在他们的病房接受采访。将使用急性冠脉综合征症状清单、加拿大心血管学会心绞痛分类工具以及医院焦虑和抑郁量表来收集数据。这项研究的结果将为以下方面提供基础：(1)开发基于性别的急性冠脉综合征症状模型，可向公众、已确诊的冠心病患者以及评估可能患有急性冠脉综合征的患者的从业者传播；(2)开发和测试可供护理人员和分诊护士使用的急性冠脉综合征症状评估工具；以及(3)开发和测试干预措施，使妇女了解其易患冠心病的可能性。

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.