Siddika Ayesha, Malik Fazila-Tun-Nesa, Kalimuddin Md, Hasan Nahidul, Ahmed Nazir, Badiuzzaman Mohammad, Banik Dhiman, Huq Tawfiq S, Ishraquzzaman Mir, Rahman Faria
Internal Medicine, Bangladesh College of Physicians and Surgeons, Dhaka, BGD.
Cardiology, National Heart Foundation Hospital & Research Institute, Dhaka, BGD.
Cureus. 2024 Feb 21;16(2):e54617. doi: 10.7759/cureus.54617. eCollection 2024 Feb.
The chance of coronary artery disease (CAD) is much higher in women who have gone through menopause than in those who have not, owing to hormonal defense against atherosclerosis. More advanced CAD and several comorbidities were observed in postmenopausal women. Nevertheless, there is a paucity of information comparing the angiographic severity of acute coronary syndrome (ACS) in premenopausal and postmenopausal women of different ages. This research sought to determine the Friesinger score's use in evaluating the degree of CAD in premenopausal and postmenopausal women with ACS.
A total of 145 female patients with ACS were included in this cross-sectional observational research. Depending on the stage of menopause, they were categorized into two groups: group I (premenopausal) and group II (postmenopausal). The study examined the differences in clinical data and the severity of coronary angiographic features based on the Friesinger score between the premenopausal and postmenopausal ACS groups.
A statistically significant difference (p = 0.001) was found in the mean age of premenopausal ACS patients, which was 41.53 ± 5.45 years, and postmenopausal ACS patients, which was 57.23 ± 7.45 years. Between the premenopausal group (31.4% vs. 17.1%; p = 0.04 and 31.4% vs. 15.7%; p = 0.002) and postmenopausal group (48.6% vs. 20%; p = 0.001), there was a greater prevalence of normal coronary angiography, single-vessel disease, and triple-vessel disease. Comparing the postmenopausal group to the premenopausal group, the high to intermediate Friesinger score (11-15) was found to be considerably higher (2.9% vs. 1.4%; 72.9% vs. 50%; p = 0.003).
Prior to menopause, single-vessel disease and normal coronary angiography were more common, whereas postmenopausal individuals had triple-vessel disease. The postmenopausal group's CAD was found to be more severe than the premenopausal group's according to the Friesinger score used for severity evaluation.
由于激素对动脉粥样硬化的防御作用，经历绝经的女性患冠状动脉疾病（CAD）的几率远高于未绝经的女性。绝经后女性中观察到更严重的CAD和多种合并症。然而，关于不同年龄的绝经前和绝经后女性急性冠状动脉综合征（ACS）血管造影严重程度比较的信息匮乏。本研究旨在确定弗赖辛格评分在评估绝经前和绝经后ACS女性CAD程度中的应用。
本横断面观察性研究共纳入145例女性ACS患者。根据绝经阶段，将她们分为两组：I组（绝经前）和II组（绝经后）。该研究基于弗赖辛格评分，考察绝经前和绝经后ACS组临床数据及冠状动脉造影特征严重程度的差异。
绝经前ACS患者平均年龄为41.53±5.45岁，绝经后ACS患者平均年龄为57.23±7.45岁，差异有统计学意义（p = 0.001）。绝经前组（31.4%对17.1%；p = 0.04以及31.4%对15.7%；p = 0.002）和绝经后组（48.6%对20%；p = 0.001）中，冠状动脉造影正常、单支血管病变和三支血管病变的患病率更高。将绝经后组与绝经前组比较，发现弗赖辛格高至中度评分（11 - 15）显著更高（2.9%对1.4%；72.9%对50%；p = 0.003）。
绝经前，单支血管病变和冠状动脉造影正常更为常见，而绝经后个体则以三支血管病变为主。根据用于严重程度评估的弗赖辛格评分，发现绝经后组的CAD比绝经前组更严重。
