A Study On Risk Factor Profile And Disease Pattern Of Women Younger Than 50 Years Old With Acute Coronary Syndrome

Objective:As in recent years mortality rate in women is rising with cardiovascular diseases than any other illnesses,there are limited studies on young women suffering from acute coronary syndrome.The purpose of this research is to investigate and compare the risk factors,clinical symptoms and biochemical profiles in young non-menopausal and menopausal women that are below the age of 50 years to understand how the disease is presented and what risk factors are commonly prevalent in these young women.Patients and methods:This retrospective study was conducted in the Cardiology department of Second Affiliated Hospital Of Dalian Medical University,a tertiary care hospital in Dalian,China.According to the hospital records,25137 coronary heart disease patients were treated from January 2002 to December 2018.Among these patients,1911 are men and 215are women below the age of 50 years.This study includes two hundred consecutive cases diagnosed with acute coronary syndrome by clinical presentation and coronary angiogram findings from January 2002to December 2018,below the age of 50 years.All patients were drawn from two tertiary care hospitals of Dalian,The Second Affiliated Hospital Of Dalian Medical University and Dalian Central Hospital.Women with coronary heart disease due to secondary illnesses were excluded.The study population was then divided into two groups,non-menopausal group(153 women)and menopausal group(47 women).Based on their clinical presentation both groups were compared separately and various related data was gathered by searching electronic records like baseline risk factors,clinical symptoms and diagnoses,biochemical values and severity of coronary lesions from coronary angiograms.Baseline characteristics are reported as numbers and percentages for categorical variables and as mean±standard deviation.We used?~2 test for baseline categorical variables and independent samples t test for continuous variables to compare groups.Pearson correlation test was performed for R~2 values.Statistical significance for all analysis was defined as P<0.05Results:From a total of 200 patients,153 were in non-menopausal group with mean age of(45.49±3.95)years and 47 in the menopausal group with mean age of(47.65±4.41)years,P<0.01.In the traditional risk factors,prevalence of family history was significantly higher in non-menopausal women than menopausal women(P<0.05).Based on their clinical presentation,we found that most of the menopausal women suffered with unstable angina(UA)while incidence of micro-vascular disease was higher in non-menopausal group.More young non-menopausal women suffered with acute myocardial infarction(AMI)than menopausal women.Biochemical profile revealed that levels of cardiac biomarker were higher in non-menopausal women(P<0.01)and levels of low-density lipoproteins were high in menopausal women(P<0.05).Positive correlations were found between syntax score and cardiac biomarkers(P<0.01)as well as with white blood cells(P<0.05).Conclusion:The incidence of acute coronary syndrome is low in young women under 50 years of age.In this age population,acute coronary syndrome is caused by coronary artery disease.In young non-menopausal women,acute myocardial infarction incidence is higher and severer than menopausal women.Micro-vascular disease is common in young women with acute coronary syndrome.Traditional risk factors like hypertension,dyslipidemia and diabetes are higher in both groups but family history is the most significant risk factor to cause acute coronary syndrome.