Abstract

Background: Coronary disease is the most frequent disease and cause of mortality in women. The aim of this study was to examine gender effects in acute anterior ST-elevation myocardial infarction (STEMI) and primary percutaneous intervention (PPCI) on coronary artery and myocardial perfusion and left ventricular systolic function. Methods: 184 consecutive patients, 33 women, with acute anterior STEMI treated by PPCI were evaluated. TIMI flow, myocardial blush grade (MBG) in the left anterior descending (LAD) coronary artery, ST-Elevation resolution, LAD blood velocity parameters, diastolic deceleration time (DDT) and left ventricular systolic function parameters, early and late post-PPCI, were measured. Results: Women were older (69 ± 11.9 vs. 58.2 ± 11.9, p < 0.0001), had lower weight (73.2 ± 14.1 vs. 85.2 ± 15.2 kg, p < 0.005), less smokers (61.9% vs. 84%, p < 0.05), less diabetics (28.6% vs. 42.7%, p < 0.05), but more hypertension (79.3% vs. 63%, p = < 0.05). Time intervals till PPCI were similar. TIMI grades before and after PPCI were similar. MBG > 1 before PPCI was found in 20% of women and 9.4% in men, p < 0.05; however after PPCI, MBG in men and women were similar. Women had larger extent of ST-elevation resolution 2.5 ± 2.12 mm while men had 1.375 ± 1.19 mm, p < 0.05. 71.4% of women had LAD-DDT > 600 msec, while only 43.3% of men, p < 0.05. Left ventricular systolic function parameters were similar in women and men. Conclusions: Women with anterior STEMI treated by PPCI were older, had lower body weight, with less smoking and diabetes mellitus. Women had more ST-elevation resolution and higher rates of late LAD-DDT > 600 msec. Left ventricular systolic function in women was similar to that in men.

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