Symptoms of Acute Coronary Syndrome in Medical Regulation

Study Overview
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Brief Summary
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The main objective was to analyze the impact of the gender of the attending physician in the differences in the management of ST+ ACS between men and women. This study will be conducted in partnership with the interventional cardiology team of the CHR Metz-Thionville and SAMU (emergency call center) of Moselle, which has a detailed registry of coronary angiographies at the center. A retrospective observational study will be carried out over a typical period outside of covid at the CHR Metz Mercy (2021-2022) based on coronary angiographies performed in the context of ST+ ACS at the CHR of patients referred by the center 15. The patient's medical record will be analyzed, going back to his call to the 15 via tape listening. The number of subjects required being calculated at 104 men and 104 women, these patients will be selected from the database of our cardiologist colleagues and we will match one man to one woman by comparing the delays of several items (1st medical contact, time of 1st ECG, medicalization or not, delay of call to the cardiologist, delay of coronary angiography...) according to the sex of the regulator. The consequences of a difference in management will be also evaluated by analyzing in-hospital mortality, mortality at 30 days of management, and functional sequelae at discharge (grades of dyspnea, disturbance of myocardial contractility, LVEF at discharge). This study based on the differences in questioning according to the gender of the regulating physician would allow better identification of the factors that increase the delay in the management of ST+ ACS in women, and to find avenues of correction in order to limit the loss of opportunity for patients. The patients included who are still alive will receive a notification of non-objection by mail.

Official Title
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Symptoms of Acute Coronary Syndrome in Medical Regulation: a Retrospective Study

Conditions
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Acute Coronary Syndrome

Intervention / Treatment
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* Other: symptoms of a myocardial infarction


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient with emergency coronary angiography for ST+ ACS having made a call to the Emergency Center for the same reason Exclusion Criteria: non-real ST+ ACS

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: symptoms of a myocardial infarction|Analysis of the differences in symptoms of a myocardial infarction between a man and a woman|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delay between the call to the emergency center and the first contact with a physician | Delay (minutes:seconds) | End of the call to the emergency center, less than 10 min | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delay between the call to the emergency center and the first electrocardiogram | Delay (hours:minutes) | At hospital discharge, an average of 2 hours | 
| Dispatch of a medical ambulance (Y/N) | Number (%) | End of the call to the emergency center, an average of 20 min | 
| Delay between the call to the emergency center and the first coronary angiography | Delay (minutes) | At hospital discharge, an average of 2 hours | 
| In-hospital mortality | Number (%) | 30 days after the call to emergency center | 
| Day 30 mortality | Number (%) | 30 days after the call to emergency center | 
| Left Ventricular Ejection Fraction | Percentage | At hospital discharge, less than 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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acute coronary syndrome, out-hospital care, medical regulation