Division of Cardiovascular Medicine, University of Michigan, 1500 E. Medical Center Drive, SPC 5853, Ann Arbor, MI, 48109-5853, USA,
Clin Res Cardiol. 2015 Aug;104(8):648-55. doi: 10.1007/s00392-015-0827-2. Epub 2015 Feb 17.
Young women with acute coronary syndrome (ACS) may represent a high risk group, but little is known about specific age and sex differences in clinical characteristics, treatment, outcomes, and trends over time.
Data from 3237 men and women admitted with an ACS event from 1999 to 2006 were analyzed. Patients were grouped by sex and age less than 55 years. Demographics, presentation, treatment, and outcomes at 6 months were analyzed. Primary outcomes included mortality, recurrent myocardial infarction, rehospitalization, and stroke at 6 months. Secondary analyses assessed risk factors, management, and trends over time.
Women under 55 years represented 8% of the entire cohort, and 26% of patients under age 55 years. Compared to older women, young women were more likely to be smokers (51 vs. 14%, p < 0.001) and obese (44 vs. 34%, p = 0.006). Young women had more diabetes and hypertension than young men. Mortality was lowest among young women and did not change over time. Young women received less treatment with aspirin, beta blockers, lipid-lowering agents, and ACE inhibitors, and underwent less coronary angiography and stenting than young men (44 vs. 59%, p < 0.001). Rehospitalization was higher among young women than young men (37 vs. 27%, p < 0.001), with no change over time.
Modifiable risk factors such as smoking, obesity, diabetes, and hypertension should be addressed in young women. Following ACS, young women received fewer evidence-based medications, were treated less invasively, and had higher readmission rates within 6 months compared to young men.
患有急性冠状动脉综合征 (ACS) 的年轻女性可能代表一个高风险群体，但对于特定年龄和性别在临床特征、治疗、结局和随时间变化的趋势方面的差异知之甚少。
分析了 1999 年至 2006 年期间因 ACS 入院的 3237 名男性和女性患者的数据。根据性别和年龄小于 55 岁分组。分析了 6 个月时的人口统计学、表现、治疗和结局。主要结局包括 6 个月时的死亡率、复发性心肌梗死、再住院和卒中等。二次分析评估了危险因素、管理和随时间变化的趋势。
年龄小于 55 岁的女性占整个队列的 8%，年龄小于 55 岁的患者中占 26%。与年龄较大的女性相比，年轻女性更有可能吸烟（51%对 14%，p<0.001）和肥胖（44%对 34%，p=0.006）。年轻女性的糖尿病和高血压患病率高于年轻男性。年轻女性的死亡率最低，且随时间变化无变化。年轻女性接受阿司匹林、β受体阻滞剂、降脂药和 ACE 抑制剂治疗的比例较低，接受冠状动脉造影和支架置入术的比例也低于年轻男性（44%对 59%，p<0.001）。与年轻男性相比，年轻女性的再住院率更高（37%对 27%，p<0.001），且随时间变化无变化。
应在年轻女性中解决可改变的危险因素，如吸烟、肥胖、糖尿病和高血压。ACS 后，与年轻男性相比，年轻女性接受的循证药物较少，接受的侵入性治疗较少，6 个月内的再入院率较高。
