{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T11:48:16Z","timestamp":1788608896909,"version":"build-2803163510"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Women with ST\u2010segment\u2013elevation myocardial infarction experience delays in reperfusion compared with men with little data on each time component from symptom onset to reperfusion. This study analyzed sex discrepancies in patient delays, prehospital system delays, and hospital delays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Consecutive patients with ST\u2010segment\u2013elevation myocardial infarction treated with percutaneous coronary intervention across 30 hospitals in the Victorian Cardiac Outcomes Registry (2013\u20132018) were analyzed. Data from the Ambulance Victoria Data warehouse were used to perform linkage to the Victorian Cardiac Outcomes Registry for all patients transported via emergency medical services (EMS). The primary end point was EMS call\u2010to\u2010door time (prehospital system delay). Secondary end points included symptom\u2010to\u2010EMS call time (patient delay), door\u2010to\u2010device time (hospital delay), 30\u2010day mortality, major adverse cardiovascular events, and major bleeding. End points were analyzed according to sex and adjusted for age, comorbidities, cardiogenic shock, cardiac arrest, and symptom onset time. A total of 6330 (21% women) patients with ST\u2010segment\u2013elevation myocardial infarction were transported by EMS. Compared with men, women had longer adjusted geometric mean symptom\u2010to\u2010EMS call times (47.0 versus 44.0\u00a0minutes;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), EMS call\u2010to\u2010door times (58.1 versus 55.7\u00a0minutes;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), and door\u2010to\u2010device times (58.5 versus 54.9\u00a0minutes;\n                      <jats:italic>P<\/jats:italic>\n                      =0.006). Compared with men, women had higher 30\u2010day mortality (odds ratio [OR], 1.38; 95% CI, 1.06\u20131.79;\n                      <jats:italic>P<\/jats:italic>\n                      =0.02) and major bleeding (OR, 1.54; 95% CI, 1.08\u20132.20;\n                      <jats:italic>P<\/jats:italic>\n                      =0.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Female patients with ST\u2010segment\u2013elevation myocardial infarction experienced excess delays in patient delays, prehospital system delays, and hospital delays, even after adjustment for confounders. Prehospital system and hospital delays resulted in an adjusted excess delay of 10\u00a0minutes compared with men.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.019938","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T05:19:55Z","timestamp":1624339195000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":60,"title":["Sex Differences in Prehospital Delays in Patients With ST\u2010Segment\u2013Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3089-1062","authenticated-orcid":false,"given":"Julia","family":"Stehli","sequence":"first","affiliation":[{"name":"School of Clinical Sciences at Monash Health Monash Cardiovascular Research Centre Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diem","family":"Dinh","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics School of Public Health and Preventive Medicine Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2353-9776","authenticated-orcid":false,"given":"Misha","family":"Dagan","sequence":"additional","affiliation":[{"name":"Department of General Medicine The Alfred Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4518-5948","authenticated-orcid":false,"given":"Stephen J.","family":"Duffy","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics School of Public Health and Preventive Medicine Monash University Melbourne Australia"},{"name":"Department of Cardiology The Alfred Hospital Melbourne Australia"},{"name":"Baker Heart and Diabetes Institute Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Brennan","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics School of Public Health and Preventive Medicine Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Smith","sequence":"additional","affiliation":[{"name":"Centre for Research and Evaluation Ambulance Victoria Melbourne Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1579-9279","authenticated-orcid":false,"given":"Emily","family":"Andrew","sequence":"additional","affiliation":[{"name":"Centre for Research and Evaluation Ambulance Victoria Melbourne Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziad","family":"Nehme","sequence":"additional","affiliation":[{"name":"Centre for Research and Evaluation Ambulance Victoria Melbourne Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9173-3944","authenticated-orcid":false,"given":"Christopher M.","family":"Reid","sequence":"additional","affiliation":[{"name":"Centre for Research and Evaluation Ambulance Victoria Melbourne Australia"},{"name":"School of Public Health Curtin University Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Lefkovits","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics School of Public Health and Preventive Medicine Monash University Melbourne Australia"},{"name":"Department of Cardiology Royal Melbourne Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8686-2709","authenticated-orcid":false,"given":"Dion","family":"Stub","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics School of Public Health and Preventive Medicine Monash University Melbourne Australia"},{"name":"Department of Cardiology The Alfred Hospital Melbourne Australia"},{"name":"Centre for Research and Evaluation Ambulance Victoria Melbourne Australia"},{"name":"Baker Heart and Diabetes Institute Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6289-583X","authenticated-orcid":false,"given":"Sarah","family":"Zaman","sequence":"additional","affiliation":[{"name":"School of Clinical Sciences at Monash Health Monash Cardiovascular Research Centre Monash University Melbourne Australia"},{"name":"Department of Cardiology Westmead Hospital Sydney Australia"},{"name":"Westmead Applied Research Centre University of Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.22.2941"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012188"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182742c84"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.044107"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/imj.12405"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq057"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-315034"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.109.892372"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.109.852608"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2018-313959"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.005968"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012161"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872618810410"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.04.017"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004521"},{"key":"e_1_3_1_18_2","unstructured":"Making the Invisible Visible; Heart Foundation Women and heart disease. Published January 30 2018. Available at: https:\/\/www.heartfoundation.org.au\/getmedia\/f9e4967e\u20106f4e\u20104e71\u20109b82\u2010bc1e3b1c5623\/Heart_Foundation_Annual_Review.pdf. Accessed April 24 2021."},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2017.07.013"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2017.01.023"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1071\/AH11161"},{"key":"e_1_3_1_22_2","unstructured":"OpenDocument Australian Bureau of Statistics. Socio\u2010Economic Indexes for Areas (SEIFA). Cat no. 2033.0.55.001. Published: March 27 2018. Available at: https:\/\/www.abs.gov.au\/AUSSTATS\/abs@.nsf\/Lookup\/2033.0.55.001Main+Features12016?. Accessed April 24 2021."},{"key":"e_1_3_1_23_2","unstructured":"Australian Bureau of Statistics . Measures of socioeconomic status. Cat no. 1244.0.55.001. Published: June 22 2011. Available at: https:\/\/www.ausstats.abs.gov.au\/Ausstats\/subscriber.nsf\/0\/367D3800605DB064CA2578B60013445C\/$File\/1244055001_2011.pdf. Accessed April 24 2021."},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1038"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.009449"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV12I5A93"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020211"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.031650"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.10.067"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.005948"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.01.040"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2016.06.789"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.039"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1038"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007021"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.117.005706"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.07.162"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.03.521"},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.08.865"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.019938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:12:43Z","timestamp":1715584363000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.019938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,6]]},"references-count":38,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2021,7,6]]}},"alternative-id":["10.1161\/JAHA.120.019938"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.019938","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,6]]},"assertion":[{"value":"2021-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e019938"}}