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No gender difference in the extent of myocardial ischemia in non-ST elevation myocardial infarction.
MedLine Citation:
PMID:  22752464     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.Design and 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).Conclusion: 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:
Mai T Lønnebakken; Jan E Nordrehaug; Eva Gerdts
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-2
Journal Detail:
Title:  European journal of preventive cardiology     Volume:  -     ISSN:  2047-4881     ISO Abbreviation:  Eur J Prev Cardiol     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101564430     Medline TA:  Eur J Prev Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Institute of Medicine, University of Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Norway.
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