Format

Send to

Choose Destination
Am J Cardiol. 2017 Nov 15;120(10):1727-1733. doi: 10.1016/j.amjcard.2017.07.106. Epub 2017 Aug 8.

Comparison of Electrocardiographic Characteristics in Men Versus Women ≤ 55 Years With Acute Myocardial Infarction (a Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients Substudy).

Author information

1
Coronary Unit, Cardiology Service, Vall d'Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, CIBER-CV, Barcelona, Spain. Electronic address: jabarrabes@vhebron.net.
2
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; Columbia University Medical Center, New York, New York.
3
Coronary Unit, Cardiology Service, Vall d'Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, CIBER-CV, Barcelona, Spain.
4
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
5
Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
6
Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
7
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
8
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
9
University of Missouri Kansas City, Saint Luke's Mid America Heart Institute, Kansas City, Missouri.
10
Centro Nacional de Investigaciones Cardiovasculares, Instituto de Investigación i+12, Cardiology Department, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.
11
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.

Abstract

Young women with acute myocardial infarction (AMI) have a worse prognosis than their male counterparts. We searched for differences in the electrocardiographic presentation of men and women in a large, contemporary registry of young adults with AMI that could help explain gender differences in outcomes. The qualifying electrocardiogram was blindly assessed by a central core lab in 3,354 patients (67% women) aged 18 to 55 years included in the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients study. Compared with men, women did not have a different frequency of sinus rhythm, and they had shorter PR and QRS intervals and longer QTc intervals. Intraventricular conduction disturbances were not different among genders. Notably, women were more likely than men to have abnormal Q waves in anterior leads and a lower frequency of Q waves in other territories. ST-segment elevation myocardial infarction (STEMI) diagnosis was less frequent in women than in men (44.6% vs 55.1%, p < 0.001). Among patients with STEMI, women had less magnitude and extent of ST-segment elevation than men. In patients with non-STEMI, the frequency, magnitude, and extent of ST-segment depression were not different among genders, but women had anterior ST-segment depression less frequently and anterior negative T waves more frequently compared with men. These differences remained statistically significant after adjusting for baseline characteristics. In conclusion, there are significant gender differences in the electrocardiographic presentation of AMI among young patients. Further studies are warranted to evaluate their impact on gender-related differences in the management and outcomes of AMI.

PMID:
28865896
DOI:
10.1016/j.amjcard.2017.07.106
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center