Abstract | OBJECTIVES: BACKGROUND: Sex differences persist in ACS presentation, management, and outcomes. The impact of sex differences on prehospital pain management of ACS with opioids is unknown. METHODS: RESULTS: A total of 10,547 patients were included (female: 2775 [26%]). Opioids were administered to 1585 (57%) females, 5068 (65%) males (p < 0.001). Adjusted 30-day MACE was similar between opioid groups in both sexes (female: odds ratio [OR]: 1.21, confidence interval [CI] 0.82-1.79, p = 0.34; male: OR: 0.89, CI: 0.68-1.16, p = 0.40). Median pain score at presentation was 6 (interquartile range [IQR]: 4, 8) for both sexes. Median opioid dose was 2.5 mg (IQR: 0, 10) in females and 5 mg (IQR: 0, 10) in males (p < 0.001), with similar pain relief achieved. Adjusted rates of TIMI 0-1 pre-PCI were higher in patients administered opioids (female: OR 2.9, CI: 2.07-4.07, p < 0.001; male: OR: 2.67, CI: 2.19-3.25, p < 0.001). CONCLUSIONS: Female patients undergoing PCI received less opioid analgesia, but no sex differences in prehospital pain scores were seen. Opioid administration was associated with impaired antegrade flow in the culprit artery in both sexes, but not short-term MACE. Trials evaluating nonopioid analgesics in ACS are needed.
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Authors | Emilia Nan Tie, Himawan Fernando, Ziad Nehme, Diem Dinh, Emily Andrew, Angela Brennan, Sarah Zaman, Danny Liew, Michael Stephenson, Jeffrey Lefkovits, Karlheinz Peter, Stephen J Duffy, James Shaw, Karen Smith, Dion Stub |
Journal | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
(Catheter Cardiovasc Interv)
Vol. 99
Issue 4
Pg. 989-995
(03 2022)
ISSN: 1522-726X [Electronic] United States |
PMID | 35066983
(Publication Type: Journal Article)
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Copyright | © 2022 Wiley Periodicals LLC. |
Chemical References |
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Topics |
- Acute Coronary Syndrome
(drug therapy, therapy)
- Analgesia
- Analgesics, Opioid
(adverse effects)
- Emergency Medical Services
- Female
- Humans
- Male
- Pain
(etiology)
- Pain Management
- Percutaneous Coronary Intervention
(adverse effects)
- Sex Characteristics
- Treatment Outcome
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