Objectives: Myocardial necrosis after ST-segment elevation myocardial infarction (STEMI) can cause left ventricular systolic dysfunction, which has been associated with poor outcomes. Some authors have reported that women have higher mortality rates after primary percutaneous coronary intervention (PCI), but differences between the sexes with regard to recovery of ejection fraction (EF) in patients with STEMI receiving primary PCI have not been evaluated. We aimed to assess the effect of sex on EF recovery in patients with anterior wall STEMI after primary PCI.
Patients and methods: A total of 202 consecutive patients (134 men) admitted due to anterior wall STEMI to our hospital over 44 months were evaluated. All patients were taken directly to the Cardiac Catheterization Laboratory for primary PCI. Baseline clinical variables were collected, and left ventricular ejection fraction (LVEF) was measured by echocardiography using the biplane Simpson model on the day after PCI and 6 months later.
Results: Women were significantly older than men (66.9±8.5 vs. 59.5±9.8, P<0.001). They also had a higher prevalence of hypertension and were less likely to be smokers compared with men. The time from symptom onset to hospital admission was longer in women than in men (8.9±3.0 vs. 7.8±2.4 h, P=0.048). At 1 day and 6 months after PCI, the EF was lower in women compared with men. The difference in values between 1 day and 6 months after PCI was also significantly lower in women compared with men (3.0±2.3 vs. 5.8±3.7, P<0.001). Multivariable linear regression analyses showed that being female was a significant predictor of LVEF recovery, even after adjustment for important clinical covariates.
Conclusion: These data suggest that being female is an independent determinant of LVEF recovery in patients with anterior myocardial infarction after primary PCI.