title: No gender difference in the extent of myocardial ischemia in non-ST elevation myocardial infarction.
abstract: BACKGROUND
  Significant gender differences in angiographic severity of coronary artery disease (CAD) have been demonstrated among patients with non-ST-elevation myocardial infarction (NSTEMI). However, it is unknown if these gender differences are reflected in the extent of myocardial ischemia.
  
  
  METHODS
  We assessed segmental myocardial wall motion and perfusion by contrast echocardiography in 110 patients (34 women and 76 men) with NSTEMI prior to scheduled coronary angiography. The extent of myocardial ischemia using a 17-segment left ventricular (LV) model was compared to quantitative coronary angiography (QCA).
  
  
  RESULTS
  Age (70 ± 12 vs 66 ± 12 years), troponin T level (0.53 ± 0.66 vs 0.75 ± 1.32 µg/l), Thrombolysis In Myocardial Infarction (TIMI) risk score (3.2 ± 1.4 vs 3.5 ± 1.4), LV ejection fraction and cardiovascular risk factor burden did not differ between genders. As expected, women had less severe findings on coronary angiography but the extent of myocardial ischemia by contrast echocardiography was comparable in women and men. In multivariable analysis, the risk of having prognostically severe angiographic CAD increased by 29% in women and by 49% in men for every additional LV segment with ischemia, independent of TIMI risk score (both p < 0.01).
  
  
  CONCLUSIONS
  The present contrast echocardiography study in NSTEMI patients demonstrates that women with NSTEMI have the same extent of LV myocardial ischemia as men in spite of less prevalent angiographic CAD. The findings may help explain why less severe angiographic findings in women with NSTEMI are not accompanied by lower mortality.
authors: Institute of Medicine, University of Bergen, Norway.
authors: Mai T
authors: MT
authors: Lønnebakken
authors: Jan E
authors: JE
authors: Nordrehaug
authors: Eva
authors: E
authors: Gerdts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D013318:Stroke Volume; D014463:Ultrasonography; D016277:Ventricular Function, Left
chemical_list: D003287:Contrast Media