Researchers investigated whether there are gender differences in prehospital pain scores, opioid administration, and clinical outcomes among acute coronary syndrome (ACS) patients. They noted less opioid analgesia receipt among female patients undergoing percutaneous coronary intervention (PCI), but there were no gender differences in prehospital pain scores. Opioid use was linked with impaired antegrade flow in the culprit artery in both genders, but not short-term major adverse cardiac events (MACE).

• This study included 10,547 patients (female: 2775 [26%]) with ACS who underwent PCI.

• A total of 1585 (57%) females, 5068 (65%) males received opioids.

• Similar adjusted 30-day MACE was found between opioid groups in both genders (female: odds ratio [OR]: 1.21; male: OR: 0.89).

• At presentation, median pain score was 6 (interquartile range [IQR]: 4, 8) for both genders.

• In females and males, median opioid dose was 2.5 mg (IQR: 0, 10) and 5 mg (IQR: 0, 10), respectively, with similar pain relief achieved.

• In those who received opioids, there were higher adjusted rates of thrombolysis in myocardial infarction 0-1 pre-PCI (female: OR 2.9; male: OR: 2.67).