Maciej Bęćkowski1, Marek Gierlotka2, Mariusz Gąsior2, Lech Poloński2, Tomasz Zdrojewski3, Rafał Dąbrowski4, Jarosław Karwowski4, Ilona Kowalik4, Wojciech Drygas5, Hanna Szwed4. 1. 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland. Electronic address: maciejbeckowski@wp.pl. 2. 3rd Department of Cardiology, School of Medicine with The Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland. 3. Department of Preventive Medicine and Education, Medical University of Gdańsk, Gdańsk, Poland; National Institute of Public Health - National Institute of Hygiene (NIPH - NIH), Warsaw, Poland. 4. 2nd Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland. 5. Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland.
Abstract
BACKGROUND: Acute coronary syndromes (ACS) are rare in young women. The purpose of this study was to characterize risk factors (RF) predisposing to ACS in young women and evaluate possible age-related differences. METHODS AND RESULTS: We studied 1941 young women with ACS aged ≤45 years (≤45ACS) from the PL-ACS registry and compared them with two control groups: 4275 women aged 63-64 years with ACS (63-64ACS) from the PL-ACS registry and 1170 young healthy women aged ≤45 years (≤45H) without confirmed coronary artery disease (CAD), from two national, representative, cross-sectional population health surveys, NATPOL 2011 and WOBASZ. The prevalence of major RF in these three groups was as follows, respectively: (≤45 ACS vs. 63-64ACS vs. ≤45H, for all P < 0.0001): hypertension 49.8% vs. 78.1% vs. 16.8%; hypercholesterolemia 36.1% vs. 44.3% vs. 12.9%; obesity 22.3% vs. 28.1% vs. 15.6%; diabetes 10.6% vs. 29.9% vs. 1.8% and smoking 48.7% vs. 22.2% vs. 39%. Healthy women had the lowest number of major RF (1.7 ± 1.2 vs. 2.0 ± 1.1 vs. 1.1 ± 1.0). No RF was found in 16.7% vs. 8.2% vs. 34.4% women, respectively. Independent predictors of ACS in the ≤45ACS group included diabetes [odds ratio (OR) 6.66, 95% confidence interval (CI) 3.47-12.74]*, hypertension (OR 4.30, 95% CI 3.42-5.38)*, hypercholesterolemia (OR 3.45; 95% CI 2.60-4.29)*, and smoking (OR 1.63, 95% CI 1.34-1.98)*, *(P < 0.0001 for all). CONCLUSIONS: The prevalence of risk factors for acute coronary syndromes in young women with ACS is different to those in healthy women and to those in older women. The prevalence of smoking was higher. The strongest predictor of ACS in women ≤45 years of age was diabetes, with a 6-fold increase in risk. There is still need to improve the cardio-vascular primary prevention and health promotion in the population of young women.
BACKGROUND: Acute coronary syndromes (ACS) are rare in young women. The purpose of this study was to characterize risk factors (RF) predisposing to ACS in young women and evaluate possible age-related differences. METHODS AND RESULTS: We studied 1941 young women with ACS aged ≤45 years (≤45ACS) from the PL-ACS registry and compared them with two control groups: 4275 women aged 63-64 years with ACS (63-64ACS) from the PL-ACS registry and 1170 young healthy women aged ≤45 years (≤45H) without confirmed coronary artery disease (CAD), from two national, representative, cross-sectional population health surveys, NATPOL 2011 and WOBASZ. The prevalence of major RF in these three groups was as follows, respectively: (≤45 ACS vs. 63-64ACS vs. ≤45H, for all P < 0.0001): hypertension 49.8% vs. 78.1% vs. 16.8%; hypercholesterolemia 36.1% vs. 44.3% vs. 12.9%; obesity 22.3% vs. 28.1% vs. 15.6%; diabetes 10.6% vs. 29.9% vs. 1.8% and smoking 48.7% vs. 22.2% vs. 39%. Healthy women had the lowest number of major RF (1.7 ± 1.2 vs. 2.0 ± 1.1 vs. 1.1 ± 1.0). No RF was found in 16.7% vs. 8.2% vs. 34.4% women, respectively. Independent predictors of ACS in the ≤45ACS group included diabetes [odds ratio (OR) 6.66, 95% confidence interval (CI) 3.47-12.74]*, hypertension (OR 4.30, 95% CI 3.42-5.38)*, hypercholesterolemia (OR 3.45; 95% CI 2.60-4.29)*, and smoking (OR 1.63, 95% CI 1.34-1.98)*, *(P < 0.0001 for all). CONCLUSIONS: The prevalence of risk factors for acute coronary syndromes in young women with ACS is different to those in healthy women and to those in older women. The prevalence of smoking was higher. The strongest predictor of ACS in women ≤45 years of age was diabetes, with a 6-fold increase in risk. There is still need to improve the cardio-vascular primary prevention and health promotion in the population of young women.
Authors: Mildren A Del-Sueldo; María A Mendonça-Rivera; Martha B Sánchez-Zambrano; Judith Zilberman; Ana G Múnera-Echeverri; María Paniagua; Lourdes Campos-Alcántara; Claudia Almonte; Amalia Paix-Gonzales; Claudia V Anchique-Santos; Claudine J Coronel; Gabriela Castillo; María G Parra-Machuca; Ivanna Duro; Paola Varletta; Patricia Delgado; Verónica I Volberg; Adriana C Puente-Barragán; Adriana Rodríguez; Aida Rotta-Rotta; Anabela Fernández; Ana C Izeta-Gutiérrez; Ana E Ancona-Vadillo; Analía Aquieri; Andrea Corrales; Andrea Simeone; Bibiana Rubilar; Carolina Artucio; Carolina Pimentel-Fernández; Celi Marques-Santos; Clara Saldarriaga; Christian Chávez; Cristina Cáceres; Dahiana Ibarrola; Daniela Barranco; Edison Muñoz-Ortiz; Edith D Ruiz-Gastelum; Eduardo Bianco; Elena Murguía; Enrique Soto; Fabiola Rodríguez-Caballero; Fanny Otiniano-Costa; Giovanna Valentino; Iris B Rodríguez-Cermeño; Ivan R Rivera; Jairo A Gándara-Ricardo; Jesús A Velásquez-Penagos; Judith Torales; Karina Scavenius; Karen Dueñas-Criado; Laura García; Laura Roballo; Lucía R Kazelian; Macarena Coussirat-Liendo; María C Costa-Almeida; Mariana Drever; Mariela Lujambio; Marildes L Castro; Maritza Rodríguez-Sifuentes; Mónica Acevedo; Mónica Giambruno; Mónica Ramírez; Nancy Gómez; Narcisa Gutiérrez-Castillo; Onelia Greatty; Paola Harwicz; Patricia Notaro; Rocío Falcón; Rosario López; Sady Montefilpo; Sara Ramírez-Flores; Silvina Verdugo; Soledad Murguía; Sonia Constantini; Thais C Vieira; Virginia Michelis; César M Serra Journal: Arch Cardiol Mex Date: 2022