ST segment deviation during myocardial ischemia: are there gender differences?

Prior research indicates that women have greater ST segment shifts at the time of percutaneous transluminal coronary angioplasty (PTCA) balloon inflation than men. However, ST deviation in men and women has not been compared during balloon occlusion of the same coronary vessel.

To determine whether there is a gender difference in degree of ST deviation, 12-lead electrocardiographic (ECG) recordings were made in 45 subjects undergoing PTCA (25 men, 20 women). A total ST score was obtained by summing absolute deviations across all 12 leads. All patients had single vessel coronary artery lesions in the proximal half of one of the major epicardial arteries without evidence of collateral circulation.

There were no differences between men and women in terms of age, left ventricular hypertrophy, ejection fraction, or the Norris Coronary Prognostic Index, which combines age, history of infarction, and evidence of heart failure on chest X-ray. When comparing mean ST segment deviation in men and women, vessel to vessel, no gender differences were found.

When matched for coronary vessel, men and women have comparable ST deviation patterns during coronary occlusion with PTCA balloon inflation. Therefore, detection of myocardial ischemia related to coronary occlusion with continuous ST segment monitoring should be equally sensitive in men and women.