Background
Women have been considered to be at higher risk of complications relating to
percutaneous transluminal coronary angioplasty (PTCA) than are men. One reason for this
sex-related difference could be the ischemic response of myocardium during the procedure.
Objective
To investigate whether there are
sex-related differences in ischemic response of myocardium during elective PTCA.
Methods
Consecutive patients (
n = 192, of whom 48 were women), were subjected to
vectorcardiography during the PTCA procedure. Vectorcardiographic variables, magnitude of ST-segment vector (ST-VM), and magnitude of ST-segment vector change (STC-VM) were studied.
Results
Women were older (63 ± 10 versus 56 ± 10 years,
P < 0.001) than men in our study and more often had diabetes mellitus and hypertension. Women less often had stents implanted (24 versus 50%,
P < 0.01) and they were subjected to fewer balloon inflations (
P < 0.001), with a total inflation time shorter than that for men (
P < 0.001). Maximum STC-VM was 25% greater for women (
P < 0.05). Women reported greater maximum pain (
P < 0.05) and nitroglycerine was more frequently used for them during PTCA (
P < 0.05). Occurrence of episodes of residual ischemic STC-VM (the difference between total number of episodes and number of balloon inflations) was more common for women (3 ± 5 versus 1 ± 3,
P < 0.01). Duration of residual ischemic STC-VM episodes (the difference between total duration of episodes and duration of balloon inflations) was longer for women than it was for men (242 ± 275 versus 148 ± 233 s,
P < 0.05). In a stepwise multivariate analysis and for a matched case-control group, episodes of residual STC-VM and duration of residual STC-VM episodes still indicated that there was an independent
sex-related difference (
P < 0.01 and
P < 0.01, respectively).
Conclusions
Women more commonly develop vectorcardiographic signs of severe myocardial
ischemia, more frequently experience episodes of
ischemia and report more severe angina pectoris during elective PTCA than do men.
