Gender & Symptom Differences in Acute Coronary Syndromes

点击翻译按钮获取中文摘要

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.