title: The impact of gender difference on the effects of preinfarction angina on microvascular damage with reperfused myocardial infarction.
abstract: BACKGROUND
  Few studies have addressed gender differences in evoking preconditioning. In an experimental study, it was reported that the preconditioning effect disappeared after gonadectomy.
  
  
  OBJECTIVE
  We sought to determine the effects of preinfarction angina (PA) on myocardial damage using intravenous contrast echocardiography.
  
  
  METHODS
  We studied 334 consecutive patients with anterior myocardial infarction (AMI) who underwent successful angioplasty. All patients underwent myocardial contrast echocardiography (MCE) 14 days after percutaneous coronary intervention (PCI). Contrast defect was calculated as contrast defect area/myocardial area. Typical angina occurring in the 24-hour period preceding myocardial infarction was present in 133 patients (29 women) (group PA) and absent in 201 patients (43 women) (group non-PA). All women were postmenopausal.
  
  
  RESULTS
  The contrast defect size and peak creatinine phosphokinase (max CPK) level in women were both significantly higher than that of men in group PA (18.3% +/- 6.3% vs 11.9% +/- 9.0%; P < 0.01 and 5000 +/- 599 IU/L vs 2672 +/- 221 IU/L; P < 0.005). The functional status of the myocardium among group PA, as expressed by risk area wall motion score index, was better in men than in women at 14 days (1.1 +/- 0.8 vs 1.7 +/- 0.8; P < 0.01) and at 6 months (0.7 +/- 0.4 vs 1.6 +/- 0.6; P < 0.01). However there were no significant gender differences in group non-PA. Multivariate regression analysis showed that the female gender (P < 0.05) was a significant independent predictor for microvascular damage.
  
  
  CONCLUSIONS
  These findings suggest that preconditioning effects were attenuated in women with reperfused AMI.
authors.affiliation: Division of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan. hoso@tokushima-med.jrc.or.jp
authors.forename: Shinobu
authors.initials: S
authors.lastname: Hosokawa
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Naotsugu
authors.initials: N
authors.lastname: Murakami
authors.forename: Yohei
authors.initials: Y
authors.lastname: Tobbeto
authors.forename: Takafumi
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Pomin
authors.initials: P
authors.lastname: Chen
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Riyo
authors.initials: R
authors.lastname: Ogura
authors.forename: Keitaro
authors.initials: K
authors.lastname: Mahara
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Miyajima
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yuba
authors.forename: Takefumi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Kishi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ohtani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation; D003402:Creatine Kinase / Q000097:blood; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D009206:Myocardium / Q000201:enzymology / Q000473:pathology*; D016017:Odds Ratio; D011134:Polysaccharides; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D003402:Creatine Kinase