Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
BMC Pregnancy Childbirth. 2024 Aug 13;24(1):533. doi: 10.1186/s12884-024-06726-2.
There are many sex-specific factors affecting myocardial infarction (MI) outcomes in males and females. This study aimed to evaluate the relationship between reproductive factors and cardiovascular outcomes in women after ST-elevation MI.
This retrospective cohort study was initiated in 2016-2017 at Chamran Hospital, Isfahan, Iran. One hundred eighty women with a diagnosis of ST-elevation MI were followed up for 3 years, and any occurrence of cardiovascular events (CVs) was recorded. All information regarding reproductive factors was recorded via questionnaire. This information was compared between women with cardiovascular events and women without adverse events using a sample t test, chi-square test, and multiple backward logistic regression analysis. SPSS version 24 was used to conduct all analyses.
Sixty-four women with a mean age of 65.81 ± 13.14 years experienced CV events, and 116 women with a mean age of 65.51 ± 10.88 years did not experience CV events. A history of ischemic heart disease and diabetes mellitus were more prevalent in women with CV events (P = 0.024 and P = 0.019). After adjusting for ischemic heart disease and diabetes mellitus, oral contraceptive pill (OCP) usage was more prevalent in women with CV events than in women without CV events (60.9% vs. 40.4%, P = 0.008). There was a greater chance of CV events in women with OCP usage (OR = 3.546, P = 0.038) and a lower chance of CV events in women with greater age at menarche (OR = 0.630, P = 0.009) and longer breastfeeding duration (OR = 0.798, P = 0.041) according to multiple backward logistic regression models.
Based on this study, OCP consumption is a risk factor, while older age at menarche and longer duration of breastfeeding are protective factors for cardiovascular outcomes in women after STEMI.
有许多影响男性和女性心肌梗死（MI）结局的性别特异性因素。本研究旨在评估女性 ST 段抬高型心肌梗死后生殖因素与心血管结局的关系。
本回顾性队列研究于 2016-2017 年在伊朗伊斯法罕的 Chamran 医院启动。180 名诊断为 ST 段抬高型心肌梗死的女性患者接受了 3 年的随访，记录了任何心血管事件（CV）的发生情况。通过问卷调查记录所有生殖因素的信息。使用样本 t 检验、卡方检验和多向后向逻辑回归分析比较心血管事件患者和无不良事件患者的信息。使用 SPSS 版本 24 进行所有分析。
64 名平均年龄为 65.81±13.14 岁的女性发生 CV 事件，116 名平均年龄为 65.51±10.88 岁的女性未发生 CV 事件。有缺血性心脏病和糖尿病病史的女性发生 CV 事件的比例更高（P=0.024 和 P=0.019）。在调整了缺血性心脏病和糖尿病后，发生 CV 事件的女性中使用口服避孕药（OCP）的比例高于未发生 CV 事件的女性（60.9%比 40.4%，P=0.008）。使用 OCP 的女性发生 CV 事件的可能性更大（OR=3.546，P=0.038），而初潮年龄较大（OR=0.630，P=0.009）和母乳喂养时间较长（OR=0.798，P=0.041）的女性发生 CV 事件的可能性较小。根据多向后向逻辑回归模型。
根据本研究，OCP 消费是一个危险因素，而初潮年龄较大和母乳喂养时间较长是女性 ST 段抬高型心肌梗死后心血管结局的保护因素。
