"Make the Call, Don't Miss a Beat" Campaign: Effect on Emergency Medical Services Use in Women with Heart Attack Signs.

BACKGROUND: Our objective was to evaluate the relationship between the "Make The Call, Don't Miss a Beat" national mass media campaign and emergency medical services (EMS) use among women with possible heart attack symptoms. METHODS: We linked campaign TV public service advertisement data with national EMS activation data for 2010 to 2014. We identified EMS activations (i.e., responses) for possible heart attack symptoms and for unintentional injuries for both women and men. We estimated the impact of the campaign on the fraction of the 1.7 to 15.9 million activations of women with possible heart attack symptoms compared with 1.9 million female activations for unintentional injuries within each EMS agency and month using quasi-binomial logistic regression controlling for time and state. RESULTS: Of the 3,175 U S. counties, 90% were exposed to the campaign. However, less than 2% of U.S. counties reached moderate TV exposure (≥300 gross rating points) during the entire campaign period. We did not observe an increase in the fraction of female activations for possible heart attack during periods or in counties with higher campaign exposure. CONCLUSIONS: This mass media campaign that relied heavily on TV public service advertisements was not associated with increased EMS use by women with possible heart attack symptoms, even among counties that were more highly exposed to the campaign advertisements.

Breast arterial calcification association with coronary artery calcium scoring and implications for cardiovascular risk assessment in women.

Breast arterial calcification (BAC) is a type of medial artery calcification that can be seen incidentally on mammography. Studies have suggested association of BAC with cardiovascular risk factors, coronary artery disease (CAD), and cardiovascular morbidity and mortality. Recently published studies have also suggested a modest correlation of BAC with coronary artery calcium (CAC) scoring. Roughly 40 million mammograms are already performed annually in the United States with overlap in patients that undergo CAD screening via CAC scoring. Thus, identification of cardiovascular risk by demonstrating an association between BAC and CAC may enable an instrumental sex-specific methodology to identify asymptomatic women at risk for CAD. The purpose of this article is to review the current state of the literature for BAC and its association with CAC, to review contemporary breast cancer screening guidelines, and to discuss the clinical implications of these findings.

Assessment of women with suspected myocardial ischemia: review of findings of the Women's Ischemia Syndrome Evaluation (WISE) Study.

Coronary artery disease (CAD) is the most common cause of death in women. In general, noninvasive testing in women is less reliable compared with testing in men, and most major clinical trials in CAD have included only a minority of female subjects. The Women's Ischemia Syndrome Evaluation (WISE) Study--sponsored by the National Heart, Lung, and Blood Institute--was initiated to improve diagnostic testing in women. The study consisted of four centers that tested existing methodologies as well as innovative techniques to improve diagnostic testing in women. The WISE study also aimed to clarify physiologic determinants of myocardial ischemia and determine whether angiographically normal coronary arteries are associated with myocardial ischemia. The following discussion provides an overview of the WISE study and reviews the reported and published data from the study.