One third of women and nearly one in five men with COVID-19 and ST-segment elevation MI have no culprit lesion detectable on angiography, a conference has been told.

This is a “startling” finding, say the US researchers, considering that rates of MI with non-obstructive coronary arteries usually make up only 3.5% to 6.5% of these types of events in the absence of COVID-19 infection.

The analysis of data from a US registry logging information on cardiac events linked to COVID-19 also showed numerous differences in presentations between women and men, although there was no statistically significant difference in the high mortality rates.

“[There is] a lack of research and clear guidance on how to treat [ST-elevation MI (STEMI)] patients without an identified culprit lesion, many of which are women,” said cardiologist Dr Odayme Quesada, medical director of The Christ Hospital Women’s Heart Center in Cincinnati, Ohio.