Acute Coronary Syndrome: The Risk to Young Women

Abstract

BackgroundAlthough acute coronary syndrome (ACS) mainly occurs in patients >50 years, younger patients can be affected as well. We used an age cutoff of 45 years to investigate clinical characteristics and outcomes of “young” patients with ACS.Methods and ResultsBetween October 2010 and April 2016, 14 931 patients with ACS were enrolled in the ISACS‐TC (International Survey of Acute Coronary Syndromes in Transitional Countries) registry. Of these patients, 1182 (8%) were aged ≤45 years (mean age, 40.3 years; 15.8% were women). The primary end point was 30‐day all‐cause mortality. Percentage diameter stenosis of ≤50% was defined as insignificant coronary disease. ST‐segment–elevation myocardial infarction was the most common clinical manifestation of ACS in the young cases (68% versus 59.6%). Young patients had a higher incidence of insignificant coronary artery disease (11.4% versus 10.1%) and lesser extent of significant disease (single vessel, 62.7% versus 46.6%). The incidence of 30‐day death was 1.3% versus 6.9% for the young and older patients, respectively. After correction for baseline and clinical differences, age ≤45 years was a predictor of survival in men (odds ratio, 0.24; 95% confidence interval, 0.10–0.58), but not in women (odds ratio, 1.35; 95% confidence interval, 0.50–3.62). This pattern of reversed risk among sexes held true after multivariable correction for in‐hospital medications and reperfusion therapy. Moreover, younger women had worse outcomes than men of a similar age (odds ratio, 6.03; 95% confidence interval, 2.07–17.53).Conclusion ACS at a young age is characterized by less severe coronary disease and high prevalence of ST‐segment–elevation myocardial infarction. Women have higher mortality than men. Young age is an independent predictor of lower 30‐day mortality in men, but not in women.Clinical Trial RegistrationURL: http://clinicaltrials.gov/. Unique identifier: NCT01218776.

Impact of Normal Weight Central Obesity on Clinical Outcomes in Male Patients With Premature Acute Coronary Syndrome

“…52 Young women with ACS represent an extreme phenotype, given the protective effect of endogenous estrogen on the vascular endothelium and lipids. 53 The incidence of premature ACS among women is low 54 ; thus, we only recruited male patients with premature ACS. In recent years there is growing public awareness and increasing attention to young women with ACS.…”

Impact of Age on Risk Factors and Clinical Manifestations of Acute Coronary Syndrome: Observations From the Coronary Care Unit of Sulaimani, Iraq

“…Similar findings have been reported in previously conducted studies. 23,24,27 The results also revealed that AMI was more prevalent among male patients with 67.2%, while a smaller percentage of females (32.8%) had AMI. This finding is in good agreement with previous studies that have referred to male gender as a risk factor for ACS.…”

“…Patients were assigned into three groups according to their age: young group (<45 years), middle-age group (45-65 years), and old group (>65) based on similar studies on the same subject. [23][24][25]…”

The menopause – a new chapter giving women a lust for life

“…В исследовании с участием 2873 женщин, которые находились под наблюдением в течение 24 лет, было показано, что смертность от ССЗ в постменопаузе в 2 раза выше, чем в пременопаузальном периоде [8].…”