Acute Coronary Syndromes in Premenopausal Women: Clinical and Angiographic Findings
Background: Acute coronary syndromes in premenopausal women is uncommon and limited data is available regarding their risk factor profile and angiographic characteristics. Objectives: To determine the clinical and angiographic findings in premenopausal women presented with acute coronary syndromes. Patients and methods: Cross sectional study included 160 patients (68 premenopausal women and 92 age matched male controls) who were admitted in the coronary care unit of Ibn Al-Betar Center for Cardiac Disease and diagnosed as a cases of acute coronary syndromes between September, 2013 and June, 2014. The clinical characteristics, angiographic findings for premenopausal women were compared to age matched males. Results: Hypertension was the commonest risk factor for coronary artery disease in both premenopausal women (54.4%) and age matched males (43.5%). The prevalence of smoking was significantly lower in premenopausal women compared with age matched males (8.8% vs 63.0%, p=0.0001). There was no clear risk factor for CAD in 32.4% of premenopausal women (32.4% vs 12.0%, p=0.0006). No significant difference was noted in the prevalence of hypertension (54.4% vs 43.5%, p=0.17), diabetes mellitus (33.8% vs 27.2%, p= 0.36), dyslipidaemia (27.9% vs 35.9%, p=0.29) and family history of CAD (26.5% vs 20.7%, p=0.23) between both groups . Typical chest pain was the presenting symptom in 57.4% of premenopausal women. There was more proximal left anterior descending artery involvement in the premenopausal group (25% vs 17.4%, p=0.02). The rate of angiographically normal coronaries was more in premenopausal women (16.2% vs 9.8%, p=0.045). Conclusions: acute coronary syndrome could be considered in premenopausal women who present with chest pain and careful consideration, examination and diagnosis are essential workup steps in order to not miss this condition.