A prospective observational longitudinal study of consecutive patients (n=1422) who were admitted early for a first STEMI to one of two coronary units was carried out. Initial ECG parameters were analyzed for sex differences. Multivariate analysis was performed to identify variables associated with marked ST-segment elevation (ie, total ST-segment elevation >11 mm, according to the upper tertile of the frequency distribution).
In women (n=336), Q-wave myocardial infarction was observed more often in the initial ECG (19 % vs 15.6 % ; P<.03), the total ST-segment elevation was lower (10[6.6] mm vs 11.1[7.9] mm; P<.004), and marked ST-segment elevation was less common (26.4 % vs 35.5 % ; P<.005). There was an independent inverse association between female sex and marked ST-segment elevation (odds ratio=0.70; 95 % confidence interval, 0.52-0.96; P<.02).
In patients with STEMI, female sex was associated with a lower total ST-segment elevation and there was an independent inverse association with marked ST-segment elevation.