Myocardial Infarction in Women of Reproductive age: Risk Factors, Clinical Picture, Prognosis

Aim        To study risk factors (RF) and clinical and anamnestic features of the course and prediction in women with a preserved menstrual cycle and postmenopausal women after ST segment elevation (STEMI) and non-ST elevation myocardial infarction (NSTEMI).

Material and methods        This study included 121 women aged 32 to 55 years diagnosed with MI. The patients were divided into two groups, group 1 (study group) consisting of 60 women with preserved menstrual function (1А, STEMI; n=38; age, 48.3±5.7 years and 1B, NSTEMI; n=22; age. 49.0±4.8 years), and group 2 (control) consisting of 61 postmenopausal women (2А, STEMI; n=43; age, 49.05±4.9 years; 2B, NSTEMI; n=18; age, 49.9±3.5 years). Beside the analysis of RF and clinical features, a prediction was produced for each subgroup at one year after discharge from the hospital based on the following indexes: hospitalization for unstable angina, non-fatal MI, revascularization, cardiovascular (CV) death, and major adverse cardiac events (MACE), which included all these outcomes.

Results   In all subgroups, the most frequent RFs were arterial hypertension (AH), overweight and obesity, family history, smoking, and type 2 diabetes mellitus (DM2). Among patients with STEMI, smoking was significantly more frequently observed in the group with preserved menstrual function. Oral contraceptives were used by 3 and 6 women of reproductive age in the STEMI and NSTEMI subgroups, respectively. Incidence of STEMI as the onset of ischemic heart disease (IHD, 46.7%) was higher than in subgroup 2A (27.9 %; р=0.003). Early postinfarction angina was a more frequent complication of MI in subgroup 1A than in 2A (р=0.02).

Conclusion            The incidence rate of RFs, including AH, overweight and obesity, dyslipidemia, family history, and DM2, was similar in both STEMI and NSTEMI groups. Incidence rate of smoking was statistically significantly higher in subgroup 1A. One-year prediction for women with STEMI and NSTEMI was comparable irrespective of the presence or absence of the menstrual function.

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