ACUTE CORONARY SYMPTOMS DO NOT DIFFER IN WOMEN WITH DIABETES MELLITUS

Saturday, April 25, 2015: 10:30 AM
Laura Jean Bassi, Student , College of Nursing, University of Arizona, Tucson, AZ
Anne G. Rosenfeld, PhD, RN, FAAN, WAN , College of Nursing, University of Arizona, Tucson, AZ
Marylyn Morris McEwen, PhD, PHCNS-BC, FAAN , College of Nursing, University of Arizona, Tucson, AZ
Elizabeth P. Knight, RN, MSN , College of Nursing, University of Arizona, Tucson, AZ
Melissa Goldsmith, PhD, RN , College of Nursing, University of Arizona, Tucson, AZ
Holli A. DeVon, PhD, RN, FAHA, FAAN , College of Nursing, University of Illinois Chicago, Chicago, IL
Purpose: To determine the differences in symptoms of Acute Coronary Syndrome (ACS) in women with and without diabetes mellitus (DM) presenting to the Emergency Department (ED) with symptoms of possible ACS.

Background: Research has shown that women have different symptoms of ACS than men. However, research has been inconclusive as to whether or not DM has an effect on ACS symptoms in women. Some studies have found that people with DM experience less chest pain or have different symptoms than people without DM. However, there are few studies on how women with DM experience ACS and the majority of the studies do not have adequate sample sizes or diverse populations.  

Methods: This was a secondary data analysis of quantitative data from the study entitled, The influence of gender on symptom characteristics during acute coronary syndromes. The de-identified data set included information from the Acute Coronary Syndrome Symptom Checklist (a validated 13-item symptom checklist) and the Patient Information Questionnaire (clinical and demographic data). T-tests were run on continuous variables, Chi square analyses were used to compare each of the 13 symptoms, and logistic regression was used to determine if diabetic status predicted ACS symptoms. These tests were done using SPSS software version 20.0.

Results: The sample consisted of 112 women (mean age =65); 84 women without DM and 28 with DM. No significant difference was found in the number of symptoms (M = 6 in both groups; t=0.44, p= 0.65). Additionally, no significant differences were found between women with and without DM in any of the individual 13 symptoms. DM was not found to be a predictor of individual ACS symptoms or of number of ACS symptoms.

Implications: More research with a larger sample size is needed to confirm these findings. Nurses should continue to educate all women about the full spectrum of symptoms of ACS, regardless of whether or not they have diabetes. In addition, when assessing women in the ED, nurses do not need to differentiate between symptoms of ACS in women with and without DM.