Abstract 13848: Time to Coronary Angiography in Patients With NSTE-ACS is Longer in Women as Compared to Men

Introduction: Timely invasive coronary angiography (ICA) to restore myocardial blood flow in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) improves prognosis and reduces morbidity and mortality. NSTE-ACS practice guidelines recommend ICA <2 hours [hrs] (very high-risk) or <24 hrs (high-risk). Troponin is useful for guiding timing of ICA. However, there is little evidence comparing time to troponin and ICA in women vs. men, which could uncover important treatment differences. Therefore, the purpose of this study was to examine time to ICA and first troponin in women vs. men in a cohort of hospitalized NTSE-ACS patients. Methods: Secondary data analysis in 121 patients with NSTE-ACS; women ( n =41, 34%) vs. men ( n =80, 66%), who underwent ICA and had a troponin test. Variables of interest were obtained from the electronic health record. Results: Compared to men, women were older (67±12 vs. 62±11 years, p =0.039), had a higher proportion of diabetes (44% vs. 19%, p =0.006), and were non-smokers (61% vs. 31%, p =0.013). Time, in minutes , to first troponin did not differ between women vs. men (81.53±261.04 vs . 33.49±107.20, p =0.167), when including one outlier (one woman). Excluding this outlier, it remained non-significant (44.43±127.66 vs. 33.49±107.20, p =0.167). Overall, the time to ICA, in hours , was longer in women than men (24.01±27.64 vs. 13.83±12.89, p= 0.007). The first troponin was positive in 26 women (67%) and 53 men (69%), p =0.98; however, time to ICA, in hours , was longer in women vs. men (21.55±20.26 vs. 12.56±11.41, p= 0.014). Conclusions: In patients with confirmed NSTE-ACS, time from admission to ICA was nearly twice as long in women as compared to men. One explanation could be symptoms differences and should be explored further. Time from admission to first troponin was not statistically different (with and without oulier [one women]). Despite an equivalent rate of the first troponin being positive, time to ICA was on average 9 hours longer in women vs. men. Future studies in a larger cohort(s) using contemporary data are needed to explore possible reasons for ICA delay (symptoms and clinical characteristics) to confirm if similar trends persists and whether short- and long-term outcomes are different by sex.