Why the study?
Does female sex increase the frequency of right ventricular infarction in patients with STEMI compared to male sex?
Does female sex increase the frequency of right ventricular infarction in patients with STEMI compared to male sex?
Women with inferior STEMI have a significantly higher incidence of right ventricular infarction compared to men, highlighting an important sex-based difference in myocardial infarction presentation.
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Women with STEMI may need heightened RV monitoring; supports sex-specific risk stratification but leaves practice change open pending prospective data.
OBJECTIVE: The objective of the study was to determine whether women significantly have more frequently right ventricular infarction than men. METHODS: The study population consisted of consecutive patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous intervention. The following criteria were used for the diagnosis of right ventricular infarction: ST-segment elevation in one of the right precordial leads V4R-V6R for equal or more than 1 mm together with ST-segment elevation in at least two contiguous inferior leads. The odds ratio for the diagnosis was calculated according to gender. Searching PubMed, nine more relevant studies that used the same criteria for the diagnosis of right ventricular infarction were identified and a metanalysis was conducted. RESULTS: In our group of 517 consecutive patients with STEMI, 32 (23.5%) of 136 women and 42 (11.0%) of 381 men had RVI (odds ratio (OR) = 2.48, 95% confidence interval (CI): 1.49-4.13; P = 0.001). Two hundred and seventy-five patients had inferior STEMI and among them 32 (42.7%) of 75 women and 42 (23.1%) of 182 men, had a right ventricular infarction (OR = 2.48, 95%CI: 1.40-4.40; P= 0.002). In a meta-analysis, a total number of 4,326 patients with inferior STEMI were included. Four hundred and thirty-seven (41.4%) out of 1,056 women and 1,221 (37.3%) out of 3,270 men, had been diagnosed with RVI (OR = 1.27, 95% CI: 1.09-1.48; P = 0.021). CONCLUSION: Right ventricular infarctions occur more frequently in women than in men.
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Obradović et al. (2015) studied this question.
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