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21-07-2011 | Cardiology | Article

Married men seek earlier care for AMI


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MedWire News: Married men experiencing chest pain symptomatic of acute myocardial infarction (AMI) seek care earlier than do single men, whereas no such association is seen in women, Canadian researchers reveal.

"Earlier presentation for medical care seems to be one reason for the observed lower risk for cardiovascular (CV) death among married men, relative to their single counterparts," write Clare Atzema (Institute for Clinical Evaluative Sciences, Toronto, Ontario) and colleagues in the Canadian Medical Association Journal.

The retrospective population-based cohort analysis included 4403 patients (33.7% women) with a median age of 67.3 years, who experienced chest pain, and presented to a hospital in Ontario with acute myocardial infarction (AMI) between April 2004 and March 2005.

Delayed presentation to hospital was defined as presentation more than 6 hours after the onset of chest pain.

Overall, 2037 (46.3%) patients presented to a hospital within 2 hours and 3240 (73.6%) within 6 hours (early presentation).

Of the 3079 married patients, 75.3% presented within 6 hours of chest pain onset, compared with 67.9% of the single patients, 68.5% of the divorced patients, and 70.8% of the widowed patients.

Multivariate analysis, adjusted for potential confounders including patient demographic characteristics, clinical features and medical history, revealed that in general, married patients were 54% less likely to present to hospital more than 6 hours after chest pain onset than their single counterparts.

Specifically, married men were significantly more likely to present early compared with single men (odds ratio [OR]=0.35). However, the effect of marital status on early presentation in women was not significant.

"Women may be more likely than men to take the role of caregiver and to advise their spouses to seek early medical assessment," propose the authors.

Atzema told MedWire News that that the effect of marital status could be more ubiquitous.

"Even if the wife is not physically in the room with them when their chest pain is occurring, just knowing that if she was there she would tell him to get it checked out, would spur the husband to then seek care," she explained.

As CV disease is the most frequent cause of death in the developed world, the authors believe that the benefit of the study's findings at the population level could be "substantial."

Specifically, Atzema explained, targeted public health campaigns could reduce patient-caused delay among those at risk.

"Radio, television, and other types of advertisements could run in media that targets these groups, and these could be implemented relatively quickly if the funding was there."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Piriya Mahendra

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