Muhammad Shahid, Muhammad Irfan, Shahzad Majeed Bhatti, Nighat Majeed, Muhammad Rashid Ali, Sami Mumtaz.
Gender and Acute ST Elevation Myocardial Infarction (STEMI) a Cross Sectional Analysis.
Esculapio J Services Inst Med Sci Jan ;15(3):255-9.

Objective: To determine the gender difference in various qualitative and quantitative factors among acute ST elevation myocardial infarction (STEMI) suffering patients treated with Streptokinase at tertiary care hospital, Gujranwala, Pakistan. Methods: This cross-sectional study was carried out at the Department of Cardiology, GMC Teaching hospital, Gujranwala from June 2017 to May 2018. After written consent, the data was collected by purposive sampling. The patients admitted with STEMI of all age groups, belonging to both genders, who were treated with Streptokinase injection were included. Statistical analysis was done using SPSS version 25. Independent sample T test and Chi-square test were used for quantitative and qualitative variables respectively to determine their significant association with gender. Then, binary logistic regression analysis was also performed. The p values were taken statistically significant if < 0.05 Results: Amongst 668 patients, 77.1% were male while 22.9% were female. Female had statistically significantly less time from onset of symptoms till arrival at hospital (p=0.005), higher pulse rate at presentation (p=0.031) and higher diastolic BP at presentation (p=0.003), lower ST segment elevation on ECG both minimum (P<0.001) and maximum (p=0.002) and lower serum creatinine (p=0.033). Male had significantly higher rate of H/O IHD in their male family members of age <55 years (p<0.001) as well as in their female family members of age <45 years (p=0.007). Obesity was significantly more prevalent among female as compared to male suffering STEMI (p=0.037). Binary logistic regression model was statistically significant, p<0.05 and it explained 17.1% (Nagelkerke R2) of the variance in the gender wise grouping of patients and correctly classified 77.1% of cases. Conclusions: Significant gender difference exists in different parameters among patients who presented with STEMI. Female reached hospital earlier after symptoms onset with higher pulse rate and diastolic BP and relatively lower ST segment elevation on ECG. This may be due to their good stress escape response as compared to male that cashed in term of relatively lower their in-hospital mortality rate. Our male should be addressed for a similar quick response to their symptoms to decrease MI related mortality among them. Among STEMI patients, male had higher rate of H/O IHD in their family member while obesity was relatively more prevalent among female which is a modifiable factor.

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