[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].
OBJECTIVE
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.
Galcerá-Tomás
José
J
Unidad Coronaria, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. jose.galcera@carm.es
Melgarejo-Moreno
Antonio
A
Alonso-Fernández
Nuria
N
Padilla-Serrano
Antonio
A
Martínez-Hernández
Juan
J
Gil-Sánchez
Francisco J
FJ
Del Rey-Carrión
Amparo
A
de Gea
José H
JH
Rodríguez-García
Pascual
P
Martínez-Baño
Domingo
D
Jiménez-Sánchez
Roberto
R
Murcia-Hernández
Pilar
P
del Saz
Ana
A
D000208:Acute Disease; D000368:Aged; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000503:physiopathology*; D011446:Prospective Studies; D012737:Sex Factors
D003402:Creatine Kinase