Gender Differences in the Clinical and Angiographic Profile in STEMI Patients Undergoing Primary Angioplasty

Abstract

Background
Cardiovascular disease is the major cause of death in women and is still underrecognized and undertreated. Cardiovascular disease develops 7 to 10 years later in women
than in men. There are major differences in the prevalence of various risk factors such as
diabetes mellitus, hypertension, family history of CAD, dyslipidemia, obesity and cigarette
smoking. The presenting symptoms also differ as women are more likely to present with
atypical chest pain, neck pain, nausea, fatigue and dyspnea. Characteristics of coronary lesion
also vary widely amongst women. This often leads to a higher mortality after the first episode
of myocardial infarction and a greater incidence of complications among women
necessitating a gender specific approach to primary and secondary prevention
Objective
To study the gender specific difference in risk factors, clinical features, complications
and angiographic patterns of coronary artery involvement in patients with STEMI undergoing
primary angioplasty.
Methodology
Consecutive 113 male and 111 female patients admitted with STEMI in ICCU and
who underwent primary angioplasty were studied. Detailed history and clinical examination
were done after taking informed consent. The risk factors which were studied include
hypertension, diabetes mellitus, smoking, dyslipidemia and family history of premature
coronary artery disease. ECG and Echocardiography were taken at diagnosis and whenever
patient’s condition demanded. Invasive Coronary angiography was done in patients as a part
of primary percutaneous coronary angioplasty and SYNTAX score was calculated. Data were
coded and entered in Microsoft Excel and analyzed using IBM SPSS software.