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Gender-specific Research for Emergency Diagnosis and Management of Ischemic Heart Disease: Proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.
- Source :
- Academic Emergency Medicine; Dec2014, Vol. 21 Issue 12, p1350-1360, 11p
- Publication Year :
- 2014
-
Abstract
- Coronary artery disease ( CAD) is the most common cause of death for both men and women. However, over the years, emergency physicians, cardiologists, and other health care practitioners have observed varying outcomes in men and women with symptomatic CAD. Women in general are 10 to 15 years older than men when they develop CAD, but suffer worse postinfarction outcomes compared to age-matched men. This article was developed by the cardiovascular workgroup at the 2014 Academic Emergency Medicine ( AEM) consensus conference to identify sex- and gender-specific gaps in the key themes and research questions related to emergency cardiac ischemia care. The workgroup had diverse stakeholder representation from emergency medicine, cardiology, critical care, nursing, emergency medical services, patients, and major policy-makers in government, academia, and patient care. We implemented the nominal group technique to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Through three rounds of nomination and refinement, followed by an in-person meeting on May 13, 2014, we achieved consensus on five priority themes and 30 research questions. The overarching themes were as follows: 1) the full spectrum of sex-specific risk as well as presentation of cardiac ischemia may not be captured by our standard definition of CAD and needs to incorporate other forms of ischemic heart disease ( IHD); 2) diagnosis is further challenged by sex/gender differences in presentation and variable sensitivity of cardiac biomarkers, imaging, and risk scores; 3) sex-specific pathophysiology of cardiac ischemia extends beyond conventional obstructive CAD to include other causes such as microvascular dysfunction, takotsubo, and coronary artery dissection, better recognized as IHD; 4) treatment and prognosis are influenced by sex-specific variations in biology, as well as patient-provider communication; and 5) the changing definitions of pathophysiology call for looking beyond conventionally defined cardiovascular outcomes to patient-centered outcomes. These emergency care priorities should guide future clinical and basic science research and extramural funding in an area that greatly influences patient outcomes. [ABSTRACT FROM AUTHOR]
- Subjects :
- CHEST pain diagnosis
DIAGNOSIS
HEART anatomy
HEART disease diagnosis
HEART disease risk factors
ISCHEMIA diagnosis
ACADEMIC medical centers
AGE distribution
ANGIOGRAPHY
BIOMARKERS
CONFERENCES & conventions
CORONARY disease
EMERGENCY medicine
HEART diseases
HOSPITAL medical staff
LEADERSHIP
EVALUATION of medical care
MEDICAL protocols
STUDY & teaching of medicine
RISK assessment
SERIAL publications
Subjects
Details
- Language :
- English
- ISSN :
- 10696563
- Volume :
- 21
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Academic Emergency Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 99885183
- Full Text :
- https://doi.org/10.1111/acem.12527