Graduate Research School

Linda Coventry

Thesis

Acute Coronary Syndrome: Gender differences in clinical presentation, hospital treatment and outcome.

Summary

There are two aspects to this study which will be researched separately. In part one, this study will make use of the unique population-based research capacity of the Western Australian Data Linkage System to describe the epidemiology of and to analyse whole-of-state data, over a 19 year period (1990 – 2008). Unique aspects include the population-based nature of this study that will include risk adjustment for potential confounders. The specific research aims and objectives outlined in detail in this proposal, seek to determine gender-specific differences in clinical presentation, hospital treatment and outcome in a population cohort of ACS patients admitted to any hospital (public or private) in WA between 1990 and 2008. The primary outcome measure is survival, including in-hospital mortality, 28-day, 1 year and 5 year survival, and overall survival time. Secondary outcome measures include morbidity outcomes (length of stay and re-hospitalisation rates) and clinical performance outcomes (cardiac procedures).

In part two, this study will analyse telephone calls from St John’s Ambulance to identify gender differences in reported signs and symptoms of AMI and examine the language and expression used by the patient. This part of the study will extend the research on gender differences, as no published study could be found in the international literature that has addressed this question. Content analysis will be used to identify gender specific reported signs and symptoms of AMI and theme-orientated discourse analysis will be used to analyse language expression.

Why my research is important

As heart disease is the leading cause of death in women it is vital health professionals recognise the different symptoms of AMI in women. The results of this study will provide important and hitherto unavailable information about gender differences in ACS in Western Australia (WA), to better inform health policy, health service planning and clinical practice. The unique aspects of this study include whole-of-population (WA) and determining long-term morbidity and mortality outcomes after adjustment for confounders. The unique aspect of part two of this study will be the opportunity to identify and publish a ‘typical presentation’ for women with ACS.