To investigate sex-specific differences in the value of preclinical ischemic ECGs for identifying myocardial infarction (MI) requiring target lesion revascularization (TLR) and mortality, highlighting the significance of gender disparities in MI diagnosis.
Key Findings:
Men presented with ischemic ECG more frequently than women (63% vs. 52%; p < 0.001).
Men required TLR more often than women (68.4% vs. 53.9%; p < 0.001).
Ischemic ECG predicted TLR only in female patients (OR 1.86; 95% CI 1.38−2.54; p < 0.001).
30-day mortality was 7%, and 5-year mortality was 59%.
Ischemic ECG changes were significantly associated with intrahospital and 5-year mortality in both sexes.
Interpretation:
An ischemic prehospital ECG predicts MI requiring TLR in female patients and identifies high-risk patients for mortality in both sexes, with potential clinical applications.
Limitations:
Study design was retrospective, which may introduce bias; exclusion of STEMI patients limits generalizability to all MI cases; single-center data may not reflect broader population trends, and potential biases in retrospective studies should be acknowledged.
Conclusion:
The study highlights the importance of prehospital ischemic ECGs in identifying MI and mortality risk, particularly in female patients, emphasizing the need to address gender differences in clinical practice.
by L. E. Sams, L. Bachinger, M. Maul, L. E. Villegas Sierra, M. Woerndl, J. Tauber, K. Mourouzis, F. Korovesis, M. Klemm, L. Freyer, S. Massberg, K. D. Rizas
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