{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T10:50:45Z","timestamp":1768474245367,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008002","name":"Vancouver Coastal Health Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Women with ST\u2010elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention historically experience worse in\u2010hospital outcomes compared to men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Implementation of a regional STEMI system will reduce care gaps in reperfusion times and in\u2010hospital outcomes between women and men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>1928 patients (413 women, 21.4%) presented with an acute STEMI between June 2007 and March 2016. The population was divided into an early cohort (n\u00a0=\u2009728 patients, 2007\u2010May 2011), and a late cohort (n\u00a0=\u00a01200 patients, June 2011\u20132016). The primary endpoints evaluated were reperfusion times and in\u2010hospital outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to men, women experienced significant delays in first medical contact (FMC) to arrival at the emergency room (26.0 vs. 22.0\u2009min, p\u00a0&lt;\u20090.001) and FMC\u2010to\u2010device (109 vs. 101\u2009min p\u00a0=\u00a00.001). Women had higher incidences of post\u2010PCI heart failure and death compared to men (p\u00a0&lt;\u20090.05). Following multivariable adjustment, no mortality difference was observed for women versus men (adjusted OR; 0.82; 95% confidence interval [CI], 0.51\u20131.34; p\u00a0=\u20090.433) or for early versus late cohorts (adjusted OR; 1.04; 95% CI, 0.68\u20131.60; p\u00a0=\u00a00.856).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Following STEMI regionalization, women continued to experience significantly longer reperfusion times, although there was no difference in adjusted mortality. These results highlight the ongoing disparity of STEMI care between women and men, and suggest that regionalization alone is insufficient to close sex\u2010based care gaps.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23658","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T08:59:16Z","timestamp":1623229156000},"page":"1113-1119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of regionalizing <scp>ST<\/scp>\u2010elevation myocardial infarction care on sex differences in reperfusion times and clinical outcomes"],"prefix":"10.1002","volume":"44","author":[{"given":"Erin","family":"Rayner\u2010Hartley","sequence":"first","affiliation":[{"name":"Division of Cardiology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Royal Columbian Hospital, Division of Cardiology Fraser Health Authority  Surrey British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham C.","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Vancouver Coastal Health Authority  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassandra","family":"Fayowski","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Western University  London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Cairns","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Vancouver Coastal Health Authority  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Singer","sequence":"additional","affiliation":[{"name":"School of Population and Public Health University of British Columbia  Vancouver British Columbia Canada"},{"name":"Centre for Health Evaluation and Outcome Sciences (CHEOS), Providence Health Care Research Institute University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry","family":"Lee","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation and Outcome Sciences (CHEOS), Providence Health Care Research Institute University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Sedlak","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Vancouver Coastal Health Authority  Vancouver British Columbia Canada"},{"name":"Centre for Health Evaluation and Outcome Sciences (CHEOS), Providence Health Care Research Institute University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin H.","family":"Humphries","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Centre for Health Evaluation and Outcome Sciences (CHEOS), Providence Health Care Research Institute University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Perry\u2010Arnesen","sequence":"additional","affiliation":[{"name":"Royal Columbian Hospital, Division of Cardiology Fraser Health Authority  Surrey British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha","family":"Mackay","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation and Outcome Sciences (CHEOS), Providence Health Care Research Institute University of British 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