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  • Title: [Female sex is inversely and independently associated with marked ST-segment elevation. A study in patients with ST-segment elevation acute myocardial infarction and early admission].
    Author: Galcerá-Tomás J, Melgarejo-Moreno A, Alonso-Fernández N, Padilla-Serrano A, Martínez-Hernández J, Gil-Sánchez FJ, Del Rey-Carrión A, de Gea JH, Rodríguez-García P, Martínez-Baño D, Jiménez-Sánchez R, Murcia-Hernández P, del Saz A.
    Journal: Rev Esp Cardiol; 2009 Jan; 62(1):23-30. PubMed ID: 19150011.
    Abstract:
    INTRODUCTION AND OBJECTIVES: In patients with acute myocardial infarction, a number of variables in the initial ECG are useful prognostic indicators. The presence of ST-segment elevation, however, usually indicates the need for reperfusion therapy. The aims of this study were to investigate sex differences in the ECGs of patients with ST-elevation myocardial infarction (STEMI) and to look for a possible association between sex and marked ST-segment elevation. METHODS: A prospective observational longitudinal study of consecutive patients (n=1422) who were admitted early for a first STEMI to one of two coronary units was carried out. Initial ECG parameters were analyzed for sex differences. Multivariate analysis was performed to identify variables associated with marked ST-segment elevation (i.e., total ST-segment elevation >11 mm, according to the upper tertile of the frequency distribution). RESULTS: In women (n=336), Q-wave myocardial infarction was observed more often in the initial ECG (19% versus 15.6%; P< .03), the total ST-segment elevation was lower (10+/-6.6 mm versus 11.1+/-7.9 mm; P< .004), and marked ST-segment elevation was less common (26.4% versus 35.5%; P< .005). There was an independent inverse association between female sex and marked ST-segment elevation (odds ratio=0.70; 95% confidence interval, 0.52-0.96; P< .02). CONCLUSIONS: In patients with STEMI, female sex was associated with a lower total ST-segment elevation and there was an independent inverse association with marked ST-segment elevation.
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