title: Women react with more myocardial ischemia and angina pectoris during elective percutaneous transluminal coronary angioplasty.
abstract: BACKGROUND
  Women have been considered to be at higher risk of complications relating to percutaneous transluminal coronary angioplasty (PTCA) than are men. One reason for this sex-related difference could be the ischemic response of myocardium during the procedure.
  
  
  OBJECTIVE
  To investigate whether there are sex-related differences in ischemic response of myocardium during elective PTCA.
  
  
  METHODS
  Consecutive patients (n = 192, of whom 48 were women), were subjected to vectorcardiography during the PTCA procedure. Vectorcardiographic variables, magnitude of ST-segment vector (ST-VM), and magnitude of ST-segment vector change (STC-VM) were studied.
  
  
  RESULTS
  Women were older (63 +/- 10 versus 56 +/- 10 years, P< 0.001) than men in our study and more often had diabetes mellitus and hypertension. Women less often had stents implanted (24 versus 50%, P < 0.01) and they were subjected to fewer balloon inflations (P < 0.001), with a total inflation time shorter than that for men (P< 0.001). Maximum STC-VM was 25% greater for women (P < 0.05). Women reported greater maximum pain (P < 0.05) and nitroglycerine was more frequently used for them during PTCA (P < 0.05). Occurrence of episodes of residual ischemic STC-VM (the difference between total number of episodes and number of balloon inflations) was more common for women (3 +/- 5 versus 1 +/- 3, P< 0.01). Duration of residual ischemic STC-VM episodes (the difference between total duration of episodes and duration of balloon inflations) was longer for women than it was for men (242 +/- 275 versus 148 +/- 233 s, P < 0.05). In a stepwise multivariate analysis and for a matched case-control group, episodes of residual STC-VM and duration of residual STC-VM episodes still indicated that there was an independent sex-related difference (P < 0.01 and P < 0.01, respectively).
  
  
  CONCLUSIONS
  Women more commonly develop vectorcardiographic signs of severe myocardial ischemia, more frequently experience episodes of ischemia and report more severe angina pectoris during elective PTCA than do men.
authors.affiliation: Department of Cardiology, Huddinge Hospital, Sweden. jens.jensen@ks.se
authors.forename: J
authors.initials: J
authors.lastname: Jensen
authors.forename: S V
authors.initials: SV
authors.lastname: Eriksson
authors.forename: B
authors.initials: B
authors.lastname: Lindvall
authors.forename: P
authors.initials: P
authors.lastname: Lundin
authors.forename: C
authors.initials: C
authors.lastname: Sylven
mesh_terms: D000787:Angina Pectoris / Q000209:etiology*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003327:Coronary Disease / Q000503:physiopathology / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology; D014672:Vectorcardiography / Q000379:methods