Researchers looking into differences in care have found that gender impacts on how quickly certain patients receive care in the wake of a heart attack. The main finding shows that men are more likely than women to receive faster care.
The team, which published the results in the Canadian Medical Association Journal, says gender has a wider scope than sex and incorporates "the effects of social norms and expectations for men and women."
To understand these differences and to investigate why younger men and women with acute coronary syndrome have differences in mortality, the researchers studied 1,123 patients between the ages of 18 and 55 years old, who were recruited from centers in Canada, the US and Switzerland.
The sample size consisted of 32% women and 68% men, while the median age was 50 for women and 49 for men.
After they had been admitted to the hospital, the patients completed a survey that included questions about gender issues, such as "traditional" masculine and feminine traits, responsibility for work in the home, education level and health status.
Overall, the surveys revealed that the women were mostly from lower income brackets, were more likely to have diabetes, high blood pressure and a family history of heart disease. They also had much higher anxiety and depression levels than the men.
In terms of care time, men received access to electrocardiograms (ECGs) and fibrinolysis much faster than the women; door-to-ECG and door-to needle times were 15 and 21 minutes and 28 and 36 minutes, respectively.
Commenting on the findings, Dr. Louise Pilote, study author and clinician-researcher at McGill University Health Centre in Montréal, Canada, says:
"Anxiety was associated with failure to meet the 10-minute benchmark for ECG in women but not in men. Patients with anxiety who present to the emergency department with noncardiac chest pain tend to be women, and the prevalence of acute coronary syndrome is lower among young women than among young men."
She adds that their findings suggest triage staff may dismiss a cardiac event at first among young women with anxiety, which could be why they experienced longer door-to-ECG times.
'Feminine traits' also result in treatment delays
The study also showed that patients who visited the hospital with atypical symptoms or multiple risk factors also experienced longer delays in treatment.
Both women and men with a feminine gender identity are more likely to experience treatment delays than "masculine" patients.
But perhaps more interesting, the team found that both men and women with feminine character traits were more likely to experience treatment delays than patients who had masculine traits.
They report that both women and men who reported higher levels of feminine personality traits - including reporting being the person in the household mainly responsible for housework - were "less likely to undergo invasive procedures."
Though their findings are substantial, the study did have a few limitations. Firstly, there could have been a selection bias, given that the sample involved survivors of acute coronary syndrome.
Additionally, patients were excluded when there was missing data, which reduced the sample size further. Plus, the researchers note that "lack of data on the appropriateness of procedures limits the interpretation of results and the implications for clinical practice."
Still, the team says in light of their findings, more specific care may be needed for patients who arrive at the emergency room without chest pain, multiple risk factors or who have a feminine gender identity and role.