2024
In-Hospital Delirium and Disability and Cognitive Impairment After COVID-19 Hospitalization
Kaushik R, McAvay G, Murphy T, Acampora D, Araujo K, Charpentier P, Chattopadhyay S, Geda M, Gill T, Kaminski T, Lee S, Li J, Cohen A, Hajduk A, Ferrante L. In-Hospital Delirium and Disability and Cognitive Impairment After COVID-19 Hospitalization. JAMA Network Open 2024, 7: e2419640. PMID: 38954414, PMCID: PMC11220565, DOI: 10.1001/jamanetworkopen.2024.19640.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCognitive DysfunctionCOVID-19DeliriumFemaleHospitalizationHumansMaleMiddle AgedProspective StudiesSARS-CoV-2ConceptsIn-hospital deliriumChart-Based Delirium Identification InstrumentOlder adultsFunctional disabilityCOVID-19 hospitalizationCognitive impairmentCohort studyAssociated with increased functional disabilityHospitalized older adultsIncreased functional disabilityAssociation of deliriumPostdischarge follow-upRisk of deliriumTertiary care systemFollow-upPresence of cognitive impairmentProspective cohort studyLogistic regression modelsOlder survivorsCare systemIncreasing cognitive impairmentMain OutcomesCOVID-19Hospital dischargePrimary outcomeAssociations of Social Support With Physical and Mental Health Symptom Burden After COVID-19 Hospitalization Among Older Adults
Lee S, McAvay G, Geda M, Chattopadhyay S, Acampora D, Araujo K, Charpentier P, Gill T, Hajduk A, Cohen A, Ferrante L. Associations of Social Support With Physical and Mental Health Symptom Burden After COVID-19 Hospitalization Among Older Adults. The Journals Of Gerontology Series A 2024, 79: glae092. PMID: 38558166, PMCID: PMC11059296, DOI: 10.1093/gerona/glae092.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCOVID-19FemaleHospitalizationHumansMaleMental HealthMiddle AgedProspective StudiesSARS-CoV-2Social SupportConceptsLow social supportMental health symptomsSocial supportSymptom burdenHealth symptomsFollow-up assessmentCOVID-19 hospitalizationMedical Outcomes Study Social Support SurveyPhysical symptomsAssociation of social supportEdmonton Symptom Assessment SystemPatient Health Questionnaire-4Burden of physical symptomsMental health symptom burdenModified Edmonton Symptom Assessment SystemSocial Support SurveyParticipants' mean ageAssociated with higher burdenSupport SurveyOlder survivorsSymptom managementOlder AdultsMental healthHispanic ethnicityLongitudinal associations
2022
Rationale, Design, and Characteristics of the VALIANT (COVID‐19 in Older Adults: A Longitudinal Assessment) Cohort
Cohen A, McAvay G, Geda M, Chattopadhyay S, Lee S, Acampora D, Araujo K, Charpentier P, Gill T, Hajduk A, Ferrante L. Rationale, Design, and Characteristics of the VALIANT (COVID‐19 in Older Adults: A Longitudinal Assessment) Cohort. Journal Of The American Geriatrics Society 2022, 71: 832-844. PMID: 36544250, PMCID: PMC9877652, DOI: 10.1111/jgs.18146.Peer-Reviewed Original ResearchMeSH KeywordsAftercareAgedCOVID-19FemaleHospitalizationHumansMalePatient DischargeProspective StudiesConceptsPatient-centered outcomesCOVID-19 hospitalizationCognitive impairmentPhysical functionOlder COVID-19 survivorsCOVID-19-related symptomsCOVID-19Older adultsIntensive care unitCOVID-19 survivorsPersistent cognitive impairmentSix-month followMost older adultsThird of participantsElectronic health recordsStepdown unitAcute illnessBurdensome symptomsCare unitSupplemental oxygenMedian lengthProspective studyMean ageBlack raceBaseline interview
2021
Factors Associated With Cardiac Rehabilitation Participation in Older Adults After Myocardial Infarction
Goldstein DW, Hajduk AM, Song X, Tsang S, Geda M, Dodson JA, Forman DE, Krumholz H, Chaudhry SI. Factors Associated With Cardiac Rehabilitation Participation in Older Adults After Myocardial Infarction. Journal Of Cardiopulmonary Rehabilitation And Prevention 2021, 42: 109-114. PMID: 34799530, PMCID: PMC8881286, DOI: 10.1097/hcr.0000000000000627.Peer-Reviewed Original ResearchMeSH KeywordsAftercareAgedCardiac RehabilitationHumansMyocardial InfarctionPatient DischargeProspective StudiesConceptsAcute myocardial infarctionUtilization of CRCardiac rehabilitationCR participationOlder adultsMyocardial infarctionSensory impairmentMultivariable-adjusted logistic regression modelsNationwide prospective cohort studyOlder AMI patientsCardiac rehabilitation participationProspective cohort studyYr of educationSILVER-AMI StudyLogistic regression modelsSecondary preventionClinical factorsCohort studyPatient ageIndependent predictorsAMI patientsRehabilitation participationPsychosocial factorsCR useExtensive baseline dataFalls in older adults after hospitalization for acute myocardial infarction
Goldstein DW, Hajduk AM, Song X, Tsang S, Geda M, McClurken JB, Tinetti ME, Krumholz HM, Chaudhry SI. Falls in older adults after hospitalization for acute myocardial infarction. Journal Of The American Geriatrics Society 2021, 69: 3476-3485. PMID: 34383963, PMCID: PMC8882265, DOI: 10.1111/jgs.17398.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAgedAged, 80 and overFemaleHealth StatusHospitalizationHumansMaleMyocardial InfarctionProspective StudiesRisk FactorsUnited StatesConceptsAcute myocardial infarctionSerious fallsOlder patientsMyocardial infarctionRisk factorsAge 75Older adultsMedical record adjudicationLonger hospital stayMonths of dischargeProspective cohort studyMedical record reviewSelf-reported fallsAdults age 75Logistic regression analysisAcademic medical centerHospital stayCohort studyClinical factorsRecord reviewFunctional mobilityNew medicationsFall riskMedical CenterImpaired mobilityPresentation, Treatment, and Outcomes of Older Adults Hospitalized for Acute Myocardial Infarction According to Cognitive Status: The SILVER-AMI Study
Hajduk AM, Saczynski JS, Tsang S, Geda ME, Dodson JA, Ouellet GM, Goldberg RJ, Chaudhry SI. Presentation, Treatment, and Outcomes of Older Adults Hospitalized for Acute Myocardial Infarction According to Cognitive Status: The SILVER-AMI Study. The American Journal Of Medicine 2021, 134: 910-917. PMID: 33737057, PMCID: PMC8243828, DOI: 10.1016/j.amjmed.2021.03.003.Peer-Reviewed Original ResearchConceptsSevere cognitive impairmentAcute myocardial infarctionMyocardial infarctionCognitive impairmentOlder acute myocardial infarction patientsCognitive statusMultivariable-adjusted logistic regressionAcute myocardial infarction patientsOlder adultsRoutine cognitive screeningRisk of readmissionMedical record reviewRisk of deathPost-discharge periodMyocardial infarction patientsMyocardial infarction survivorsSILVER-AMI StudyComorbidity burdenHospital readmissionPoor outcomeRecord reviewFunctional statusInfarction patientsUnadjusted analysesInfarction survivors180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study
Dodson JA, Hajduk AM, Murphy TE, Geda M, Krumholz HM, Tsang S, Nanna MG, Tinetti ME, Ouellet G, Sybrant D, Gill TM, Chaudhry SI. 180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study. Open Heart 2021, 8: e001442. PMID: 33452007, PMCID: PMC7813425, DOI: 10.1136/openhrt-2020-001442.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionReadmission risk modelSelf-reported health statusMyocardial infarctionFunctional mobilityOlder adultsHealth statusDays of AMIFirst diastolic blood pressureChronic obstructive pulmonary diseaseIschemic ECG changesProspective cohort studyDiastolic blood pressureObstructive pulmonary diseaseLength of stayInitial heart rateFinal risk modelSILVER-AMI StudyRisk modelInitial hemoglobinCohort studyReadmission ratesBlood pressureEjection fractionHeart failure
2020
Risk Model for Decline in Activities of Daily Living Among Older Adults Hospitalized With Acute Myocardial Infarction: The SILVER‐AMI Study
Hajduk AM, Dodson JA, Murphy TE, Tsang S, Geda M, Ouellet GM, Gill TM, Brush JE, Chaudhry SI. Risk Model for Decline in Activities of Daily Living Among Older Adults Hospitalized With Acute Myocardial Infarction: The SILVER‐AMI Study. Journal Of The American Heart Association 2020, 9: e015555. PMID: 33000681, PMCID: PMC7792390, DOI: 10.1161/jaha.119.015555.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionDaily living declineSILVER-AMI StudyDaily livingOlder patientsMonths postdischargeMyocardial infarctionFunctional declineImportant patient-centered outcomesPoor long-term outcomesLonger hospital stayLong-term outcomesPatient-centered outcomesGeriatric impairmentsHospital stayAMI survivorsClinical variablesMean ageMedical recordsRisk factorsRestorative therapyPhysical activityAMI hospitalizationPsychosocial factorsUS hospitals
2019
Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study.
Dodson JA, Hajduk AM, Geda M, Krumholz HM, Murphy TE, Tsang S, Tinetti ME, Nanna MG, McNamara R, Gill TM, Chaudhry SI. Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study. Annals Of Internal Medicine 2019, 172: 12-21. PMID: 31816630, PMCID: PMC7695040, DOI: 10.7326/m19-0974.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-AMI mortalityFunctional impairmentOlder adultsCohort studyMean ageMyocardial infarctionPatient-reported health statusNet reclassification improvement indexProspective cohort studyParticipants' mean ageFinal risk modelMobility impairmentsGood discriminatory abilityRisk modelChart reviewHospital dischargePrognostic utilityBlood InstituteClinical variablesNational HeartHigh prevalenceHealth statusMortalityYounger counterpartsSex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction
Nanna MG, Hajduk AM, Krumholz HM, Murphy TE, Dreyer RP, Alexander KP, Geda M, Tsang S, Welty FK, Safdar B, Lakshminarayan DK, Chaudhry SI, Dodson JA. Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005691. PMID: 31607145, PMCID: PMC6913190, DOI: 10.1161/circoutcomes.119.005691.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overComorbidityDisability EvaluationFemaleHealth Status DisparitiesHealthcare DisparitiesHumansLife StyleMaleMyocardial RevascularizationNon-ST Elevated Myocardial InfarctionPatient AdmissionPrevalenceProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocial Determinants of HealthST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionSex-based differencesPercutaneous coronary interventionFunctional impairmentOlder adultsHospital complicationsCoronary interventionOlder patientsCoronary diseaseMyocardial infarctionAge-related functional impairmentsAge-associated functional impairmentsLower ratesPrior coronary diseaseObstructive coronary diseaseProspective observational studyNSTEMI subgroupSTEMI subgroupUnderwent revascularizationAcute myocardialChest painClinical presentationAMI subgroupRisk factorsHigh prevalenceThirty-Day Readmission Risk Model for Older Adults Hospitalized With Acute Myocardial Infarction
Dodson JA, Hajduk AM, Murphy TE, Geda M, Krumholz HM, Tsang S, Nanna MG, Tinetti ME, Goldstein D, Forman DE, Alexander KP, Gill TM, Chaudhry SI. Thirty-Day Readmission Risk Model for Older Adults Hospitalized With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005320. PMID: 31010300, PMCID: PMC6481309, DOI: 10.1161/circoutcomes.118.005320.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overFemaleGeriatric AssessmentHealth Status IndicatorsHumansMaleMyocardial InfarctionPatient AdmissionPatient ReadmissionPredictive Value of TestsProspective StudiesReproducibility of ResultsRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionReadmission risk modelFinal risk modelFunctional mobilityFunctional impairmentMyocardial infarctionOlder adultsFirst diastolic blood pressureChronic obstructive pulmonary diseaseAge-related functional impairmentsP2Y12 inhibitor useAcute kidney injuryDaily living (ADL) disabilityPatient-level factorsProspective cohort studyDiastolic blood pressureObstructive pulmonary diseasePatients of ageGeneral health statusStrongest predictorRisk modelMore comorbiditiesCause readmissionKidney injuryCohort study
2018
Development of a Clinically Feasible Process for Identifying Individual Health Priorities
Naik AD, Dindo LN, Van Liew J, Hundt NE, Vo L, Hernandez‐Bigos K, Esterson J, Geda M, Rosen J, Blaum CS, Tinetti ME. Development of a Clinically Feasible Process for Identifying Individual Health Priorities. Journal Of The American Geriatrics Society 2018, 66: 1872-1879. PMID: 30281794, PMCID: PMC10185433, DOI: 10.1111/jgs.15437.Peer-Reviewed Original ResearchConceptsPatients' health prioritiesPrimary care practicesHealth priorityCare practicesBusy primary care practicesOlder adultsMore medicationsMedical record templatesPatient prioritiesClinician facilitatorsPatientsCliniciansRecord templatesDescriptive statisticsAdultsPriority identificationAdditional settingsMore conditionsFacilitatorsMedicationsFeasibility studyCareQualitative analysisCaregiversPresentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study
Safdar B, Spatz ES, Dreyer RP, Beltrame JF, Lichtman JH, Spertus JA, Reynolds HR, Geda M, Bueno H, Dziura JD, Krumholz HM, D'Onofrio G. Presentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e009174. PMID: 29954744, PMCID: PMC6064896, DOI: 10.1161/jaha.118.009174.Peer-Reviewed Original ResearchConceptsMI-CAD patientsNonobstructive coronary arteriesMI-CADYounger patientsClinical profileCoronary arteryMyocardial infarctionTraditional cardiac risk factorsAcute myocardial infarction patientsCardiac risk factorsGestational diabetes mellitusMyocardial infarction patientsTimes higher oddsMINOCA patientsSAQ qualityVIRGO StudyClinical characteristicsHypercoaguable stateDiabetes mellitusObstructive diseaseClinical outcomesInfarction patientsRisk factorsMINOCAPsychosocial statusSex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics
Gupta A, Barrabes JA, Strait K, Bueno H, Porta‐Sánchez A, Acosta‐Vélez J, Lidón R, Spatz E, Geda M, Dreyer RP, Lorenze N, Lichtman J, D'Onofrio G, Krumholz HM. Sex Differences in Timeliness of Reperfusion in Young Patients With ST‐Segment–Elevation Myocardial Infarction by Initial Electrocardiographic Characteristics. Journal Of The American Heart Association 2018, 7: e007021. PMID: 29514807, PMCID: PMC5907538, DOI: 10.1161/jaha.117.007021.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge of OnsetElectrocardiographyFemaleHealthcare DisparitiesHumansMaleMiddle AgedMyocardial ReperfusionPredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSex FactorsSpainST Elevation Myocardial InfarctionTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsST-segment elevation myocardial infarctionElectrocardiographic characteristicsMyocardial infarctionReperfusion delayYounger patientsVentricular hypertrophyST elevationPrehospital ECGLateral leadsMultivariable logistic regression modelTimeliness of reperfusionVoltage criteriaElevation myocardial infarctionLeft ventricular hypertrophyAcute myocardial infarctionYears of ageLogistic regression modelsSex differencesClinical characteristicsCohort studyElectrocardiographic correlatesMultivariable analysisFemale sexSpanish hospitalsReperfusion guidelines
2017
Comparison of Electrocardiographic Characteristics in Men Versus Women ≤ 55 Years With Acute Myocardial Infarction (a Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients Substudy)
Barrabés JA, Gupta A, Porta-Sánchez A, Strait KM, Acosta-Vélez JG, D'Onofrio G, Lidón RM, Geda M, Dreyer RP, Lorenze NP, Lichtman JH, Spertus JA, Bueno H, Krumholz HM. Comparison of Electrocardiographic Characteristics in Men Versus Women ≤ 55 Years With Acute Myocardial Infarction (a Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients Substudy). The American Journal Of Cardiology 2017, 120: 1727-1733. PMID: 28865896, DOI: 10.1016/j.amjcard.2017.07.106.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionST-segment depressionElectrocardiographic presentationMyocardial infarctionQ wavesAnterior ST segment depressionST-segment elevation myocardial infarction diagnosisOutcome of AMIYoung AMI patientsMen Versus WomenST-segment elevationLonger QTc intervalsIntraventricular conduction disturbancesCentral core labNegative T wavesAbnormal Q wavesGender-related differencesBaseline characteristicsContemporary registryAnterior leadsMyocardial infarction diagnosisYounger patientsQTc intervalAMI patientsWorse prognosisDepression Treatment and Health Status Outcomes in Young Patients With Acute Myocardial Infarction
Smolderen KG, Spertus JA, Gosch K, Dreyer RP, D'Onofrio G, Lichtman JH, Geda M, Beltrame J, Safdar B, Bueno H, Krumholz HM. Depression Treatment and Health Status Outcomes in Young Patients With Acute Myocardial Infarction. Circulation 2017, 135: 1762-1764. PMID: 28461419, PMCID: PMC5755692, DOI: 10.1161/circulationaha.116.027042.Peer-Reviewed Original ResearchSex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction
Lu Y, Zhou S, Dreyer RP, Spatz ES, Geda M, Lorenze NP, D'Onofrio G, Lichtman JH, Spertus JA, Ridker PM, Krumholz HM. Sex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003470. PMID: 28228461, PMCID: PMC5459381, DOI: 10.1161/circoutcomes.116.003470.Peer-Reviewed Original ResearchMeSH Keywords1-Alkyl-2-acetylglycerophosphocholine EsteraseAdolescentAdultAge of OnsetBiomarkersC-Reactive ProteinChi-Square DistributionComorbidityFemaleHealth Status DisparitiesHumansInflammation MediatorsLinear ModelsMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocioeconomic FactorsUnited StatesUp-RegulationYoung AdultConceptsHigh-sensitivity C-reactive proteinAcute myocardial infarctionHigher inflammatory levelsInflammatory markersPoor health statusHealth statusYoung womenMyocardial infarctionInflammatory levelsTargeted anti-inflammatory treatmentsElevated inflammatory markersResidual cholesterol riskResidual inflammatory riskSex differencesAnti-inflammatory treatmentAnti-inflammatory therapyC-reactive proteinHigher mortality riskYoung menPhospholipase A2Years of ageCardiovascular outcomesMultivariable adjustmentPatient characteristicsSecondary prevention
2016
Gender differences in physical activity following acute myocardial infarction in adults: A prospective, observational study
Minges KE, Strait KM, Owen N, Dunstan DW, Camhi SM, Lichtman J, Geda M, Dreyer RP, Bueno H, Beltrame JF, Curtis JP, Krumholz HM. Gender differences in physical activity following acute myocardial infarction in adults: A prospective, observational study. European Journal Of Preventive Cardiology 2016, 24: 192-203. PMID: 27885060, DOI: 10.1177/2047487316679905.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAustraliaCardiac RehabilitationChi-Square DistributionExerciseExercise TherapyFemaleHealth BehaviorHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedMyocardial InfarctionOdds RatioPatient ComplianceProspective StudiesRisk FactorsSex FactorsSpainTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsAcute myocardial infarctionPost-acute myocardial infarctionMyocardial infarctionPhysical activityRegular physical activity participationYoung AMI Patients (VIRGO) studyPhysical activity recommendationsAmerican Heart AssociationPhysical activity trajectoriesNon-white raceMyocardial infarction recoveryPhysical activity participationGender differencesHospital dischargeHeart AssociationLifestyle behaviorsActivity recommendationsObservational studyInfarctionAustralian hospitalsTargeted interventionsOne monthPatientsTime pointsLonger durationEditor’s Choice-Sex differences in young patients with acute myocardial infarction: A VIRGO study analysis
Bucholz EM, Strait KM, Dreyer RP, Lindau ST, D’Onofrio G, Geda M, Spatz ES, Beltrame JF, Lichtman JH, Lorenze NP, Bueno H, Krumholz HM. Editor’s Choice-Sex differences in young patients with acute myocardial infarction: A VIRGO study analysis. European Heart Journal Acute Cardiovascular Care 2016, 6: 610-622. PMID: 27485141, PMCID: PMC5459677, DOI: 10.1177/2048872616661847.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionYoung womenTime of AMIST-segment elevation myocardial infarctionHigh clinical risk scoreSegment elevation myocardial infarctionChronic obstructive pulmonary diseaseYoung AMI patientsCardiovascular risk factorsClinical risk scorePre-hospital delayProspective cohort studyCongestive heart failureElevation myocardial infarctionObstructive pulmonary diseaseHigh-risk populationYoung menMental health statusElectrocardiogram findingsMorbid obesityCardiovascular riskCohort studyRenal failureYounger patients
2015
Sex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction
D'Onofrio G, Safdar B, Lichtman JH, Strait KM, Dreyer RP, Geda M, Spertus JA, Krumholz HM. Sex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction. Circulation 2015, 131: 1324-1332. PMID: 25792558, PMCID: PMC4652789, DOI: 10.1161/circulationaha.114.012293.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionMyocardial infarctionReperfusion therapyAcute ST-segment elevation myocardial infarctionProspective observational cohort studyYoung AMI Patients (VIRGO) studyTime guidelinesYoung womenObservational cohort studyProportion of patientsElevation myocardial infarctionPercutaneous coronary interventionYears of ageSex differencesPatients 18Reperfusion strategyCohort studyCoronary interventionFibrinolytic therapyNeedle timeYounger patientsReperfusion delayRatio of womenReperfusion guidelinesSex disparities