Background: Previous data reported worse outcome among females following acute STEMI, related at least in part to less aggressive and non-parallel treatment. We investigated the presence of gender differences in left ventricular (LV) systolic and diastolic function in patients presenting with first ST elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention(PCI).
Methods: Study population included 187 consecutive patients (81% males) presenting with STEMI and treated by primary PCI and guideline based medications. Their mean age was 58 ± 10 years. All patients underwent a comprehensive echocardiographic evaluation within 3 days of admission.
Results: Female patients were older (62 ± 11 vs. 59 ± 10 years, p=0.006), with more co-morbidities and longer symptom duration (490 ±436 vs. 365 ± 437 minutes ,p=0.013). Echocardiography demonstrated that females had significantly lower LV systolic function (47% ± 8% vs. 45% ±8%, p=0.03), lower septal and lateral e' velocities, higher average E/ e' ratio (all p 0.001), elevated systolic pulmonary artery pressure (p=0.03) and worse diastolic dysfunction (p =0.007). No significant changes were present in left atrial volumes. In a logistic multivariate analysis model, female gender emerged as an independent predictor of e' 8 cm/s (OR=10.11 CI 95% 1.23-82.32,p=0.002) and E/e' ratio 15 (OR=6.47CI 95% 1.63-25.61, p=0.008).
Conclusion: Females undergoing primary PCI for first STEMI demonstrated worse systolic and diastolic LV function, despite receiving similar treatment as males.
