Sex Differences in Acute Chest Pain Care in the ED
Sex Differences in Acute Chest Pain Care in the ED
U.S. multicenter cohort | 40,979 patients | 25 EDs | 2021
* Women had a lower 30-day risk of death or myocardial infarction than men (2.4% vs 5.2%).
* Women were less likely to be hospitalized (30.2% vs 36.0%) and to undergo objective cardiac testing (14.9% vs 19.6%), with differences remaining significant after adjustment.
* All patients were managed using a standardized high-sensitivity troponin chest pain pathway.
* Clinical message: Lower event rates in women should not lead to less thorough evaluation. Use a standardized chest pain pathway based on clinical risk assessment and hs-cTn—not sex—to guide evaluation and management.
Women may still present with non-obstructive CAD, coronary microvascular dysfunction, or coronary vasospasm.
Source: American Journal of Emergency Medicine. July 2026.
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