Coronary Artery Diseases in Women.

Dear Editor-in-Chief

Women in reproductive age are at lower risk of cardiovascular Disease (CVD), but after menopause, this is not true. Although CVD are less prevalent in women, they are followed by more mortality and complications.

In this study, we assessed the role of sex on 1266 hospitalized Acute Myocardial Infarction (AMI) patients in Birjand, center of South Khorassan Province, Eastern Iran, during 2008–2012. Out of them, 30% were women. Mean age of women was 6 yr more than that of men. Moreover, mean of FBS, cholesterol, triglyceride, and LDL was significantly higher in women (Table 1). Mortality of our patients was 8.8%, but women’s mortality was significantly higher than men were (i.e. 14.6% VS 6.3%, P<0.001).

Table 1:

Mean of age, glucose and lipids in patients with acute myocardial infarction

MEAN ±SD	AGE (yr)	FBS mg/dl	Cholesterol mg/dl	TG mg/dl	HDL mg/dl	LDL mg/dl
GROUP
Male	60.5±13.6	134.6±72.7	192.9±46.1	126.5±81.7	43.5±11.4	115.7±33.2
Female	66.2±13	147.7±87.1	208.9±48.4	143.5±92.4	48.3±13.4	125.2±33.7
P value	<0.001	0.007	<0.001	0.003	<0.001	<0/001

Male gender is accounted as an uncontrollable risk factor for CVD. When women’s diseases are talked about, reproductive and breast diseases are associated. However, the most prevalent mortality causes in women are Coronary Artery Disease (54%) and stroke (23%) in descending order. Breast cancer only covers 3% of women’s mortality (1). CVDs in women are so notorious that WHO and World Heart Federation allocated the World Heart Day motto during 2011–2013 to Health of Women’s Heart (2). On the other hand, in women, especially in low and middle-income countries, the impact of socio-economical, environmental and health behavioral factors are more than men (3).

The reason why mortality in women is higher following AMI is multifactorial. Factors such as older age, more prevalence of diabetes and dyslipidemia in women; besides, their delayed reference to hospital when having AMI, more extensive infarction, as well as heart failure are decisive (4, 5).

Thus, it is necessary that women’s knowledge about heart attack symptoms should increase so that they would refer to emergency wards earlier for sooner and treatments that are more effective if cardiac symptoms occur. Moreover, regular screening for cardiac risk factors in women – particularly diabetes and dyslipidemia- should be done in order to decrease the probability of cardiac diseases.