Gender peculiarities of clinical and instrumental indexes in patients with acute Q-wave myocardial infarction after primary coronary intervention

The aim: to determine gender differences in the course of acute Q-wave myocardial infarction in patients after primary coronary intervention. Materials and methods. Results of clinical and instrumental examination of 58 patients with acute Q-wave myocardial infarction were analyzed. Patients were...

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Main Authors: Yu. V. Savchenko, S. M. Kyselov
Format: Article
Language:English
Published: Zaporizhzhia State Medical and Pharmaceutical University 2021-10-01
Series:Zaporožskij Medicinskij Žurnal
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Online Access:http://zmj.zsmu.edu.ua/article/view/231570/239302
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author Yu. V. Savchenko
S. M. Kyselov
author_facet Yu. V. Savchenko
S. M. Kyselov
author_sort Yu. V. Savchenko
collection DOAJ
description The aim: to determine gender differences in the course of acute Q-wave myocardial infarction in patients after primary coronary intervention. Materials and methods. Results of clinical and instrumental examination of 58 patients with acute Q-wave myocardial infarction were analyzed. Patients were divided into 2 groups according to gender: group 1 (n = 33) – men, mean age 61.0 (55.0; 69.0) years, group 2 (n = 25) – women, mean age 69.0 (63.0; 78.0) years. All the patients underwent coronary angiography followed by angioplasty and stenting of the infarct-dependent coronary artery. Results. In men, the number of leukocytes was significantly higher (by 24.7 %, P = 0.02) and the plasma level of low-density lipoproteins was significantly lower (by 30.9 %, P = 0.007), there was a tendency towards a higher concentration of creatine kinase-MB (by 41.0 %, P = 0.11) at the time of hospital admission as compared to women. Women showed significantly increased thickness of the posterior wall of the left ventricle (LV) (by 7.31 %, P = 0.02) and a tendency towards the prevalence of the interventricular septum wall thickness (by 7.46 %, P = 0.1). The LV end-diastolic and end-systolic dimensions tended to prevail in men (by 2.41 %, P = 0.47 and by 7.81 %, P = 0.19, respectively). Men were found to have a lower peak A rate (by 23.37 %, P = 0.007), a higher E/A ratio (by 52.27 %, P = 0.009), LV diastolic dysfunction (DD) occurred less frequently (χ2 = 2.89, P = 0.08), and there was a tendency to develop eccentric LV hypertrophy (χ2 = 2.39, P = 0.12) and type 2 LV DD (χ2 = 3.82, P = 0.07). Type 1 DD was more common in women (χ2 = 5.71, P = 0.02). In men, there was a tendency to the formation of zones of LV akinesia (χ2 = 2.5, P = 0.09) and decreased LV ejection fraction (χ2 = 1.57, P = 0.31). Conclusions. In the acute period of Q-wave myocardial infarction after revascularization, in men, unlike in women, systolic dysfunction is developed more often. It is accompanied by acute left ventricular failure, eccentric left ventricular hypertrophy and type 2 diastolic dysfunction formation as well as signs of systemic inflammation. In women, in the acute period of Q-wave myocardial infarction after revascularization, concentric left ventricular remodeling occurs more frequently and is accompanied by type 1 left ventricular diastolic dysfunction.
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spelling doaj-art-27230ed4681c42d0b5fa034c575f30fc2025-08-20T02:01:50ZengZaporizhzhia State Medical and Pharmaceutical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102021-10-0123561462010.14739/2310-1210.2021.5.231570Gender peculiarities of clinical and instrumental indexes in patients with acute Q-wave myocardial infarction after primary coronary interventionYu. V. Savchenko0https://orcid.org/0000-0002-0027-9879S. M. Kyselov1https://orcid.org/0000-0003-0125-665XZaporizhzhia State Medical University, UkraineZaporizhzhia State Medical University, UkraineThe aim: to determine gender differences in the course of acute Q-wave myocardial infarction in patients after primary coronary intervention. Materials and methods. Results of clinical and instrumental examination of 58 patients with acute Q-wave myocardial infarction were analyzed. Patients were divided into 2 groups according to gender: group 1 (n = 33) – men, mean age 61.0 (55.0; 69.0) years, group 2 (n = 25) – women, mean age 69.0 (63.0; 78.0) years. All the patients underwent coronary angiography followed by angioplasty and stenting of the infarct-dependent coronary artery. Results. In men, the number of leukocytes was significantly higher (by 24.7 %, P = 0.02) and the plasma level of low-density lipoproteins was significantly lower (by 30.9 %, P = 0.007), there was a tendency towards a higher concentration of creatine kinase-MB (by 41.0 %, P = 0.11) at the time of hospital admission as compared to women. Women showed significantly increased thickness of the posterior wall of the left ventricle (LV) (by 7.31 %, P = 0.02) and a tendency towards the prevalence of the interventricular septum wall thickness (by 7.46 %, P = 0.1). The LV end-diastolic and end-systolic dimensions tended to prevail in men (by 2.41 %, P = 0.47 and by 7.81 %, P = 0.19, respectively). Men were found to have a lower peak A rate (by 23.37 %, P = 0.007), a higher E/A ratio (by 52.27 %, P = 0.009), LV diastolic dysfunction (DD) occurred less frequently (χ2 = 2.89, P = 0.08), and there was a tendency to develop eccentric LV hypertrophy (χ2 = 2.39, P = 0.12) and type 2 LV DD (χ2 = 3.82, P = 0.07). Type 1 DD was more common in women (χ2 = 5.71, P = 0.02). In men, there was a tendency to the formation of zones of LV akinesia (χ2 = 2.5, P = 0.09) and decreased LV ejection fraction (χ2 = 1.57, P = 0.31). Conclusions. In the acute period of Q-wave myocardial infarction after revascularization, in men, unlike in women, systolic dysfunction is developed more often. It is accompanied by acute left ventricular failure, eccentric left ventricular hypertrophy and type 2 diastolic dysfunction formation as well as signs of systemic inflammation. In women, in the acute period of Q-wave myocardial infarction after revascularization, concentric left ventricular remodeling occurs more frequently and is accompanied by type 1 left ventricular diastolic dysfunction.http://zmj.zsmu.edu.ua/article/view/231570/239302myocardial infarctionpercutaneous coronary interventionmyocardial reperfusiongender differences
spellingShingle Yu. V. Savchenko
S. M. Kyselov
Gender peculiarities of clinical and instrumental indexes in patients with acute Q-wave myocardial infarction after primary coronary intervention
Zaporožskij Medicinskij Žurnal
myocardial infarction
percutaneous coronary intervention
myocardial reperfusion
gender differences
title Gender peculiarities of clinical and instrumental indexes in patients with acute Q-wave myocardial infarction after primary coronary intervention
title_full Gender peculiarities of clinical and instrumental indexes in patients with acute Q-wave myocardial infarction after primary coronary intervention
title_fullStr Gender peculiarities of clinical and instrumental indexes in patients with acute Q-wave myocardial infarction after primary coronary intervention
title_full_unstemmed Gender peculiarities of clinical and instrumental indexes in patients with acute Q-wave myocardial infarction after primary coronary intervention
title_short Gender peculiarities of clinical and instrumental indexes in patients with acute Q-wave myocardial infarction after primary coronary intervention
title_sort gender peculiarities of clinical and instrumental indexes in patients with acute q wave myocardial infarction after primary coronary intervention
topic myocardial infarction
percutaneous coronary intervention
myocardial reperfusion
gender differences
url http://zmj.zsmu.edu.ua/article/view/231570/239302
work_keys_str_mv AT yuvsavchenko genderpeculiaritiesofclinicalandinstrumentalindexesinpatientswithacuteqwavemyocardialinfarctionafterprimarycoronaryintervention
AT smkyselov genderpeculiaritiesofclinicalandinstrumentalindexesinpatientswithacuteqwavemyocardialinfarctionafterprimarycoronaryintervention