Clinical and Angiographic Profile of ST-elevation Myocardial Infarction in Premenopausal Women

Abstract

Introduction: Ischemic heart disease and its complications are on a rise in premenopausal women unlike previously thought that estrogen provides protective effects from cardiovascular diseases. There are less number of studies for premenopausal women with ST-elevation myocardial infarction and very few took into account the clinical and angiographic pattern.
Purpose: In this study, we took into account clinical and angiographic pattern as well as certain risk factor profile.
Materials and Methods: Women <50 years admitted in the Intensive Coronary Care Unit of Government Rajaji Hospital, Madurai, with ST-elevation myocardial infarction were taken into the study (43 in number). Their clinical presentation, risk factor profile, biochemical data, electrocardiogram and echo findings, and the angiographic findings were collected. The study was conducted over a period of 1 year.
Results: In our study, most of them were diabetics, non-vegetarians were using sunflower oil or palm oil, and almost 100% had dyslipidemia. Most of them had anterior wall myocardial infarction with ejection fraction >40%. Most of them had single-vessel disease. Thirty days mortality was very less. In about five patients, none of the conventional risk factors for coronary artery disease (CAD) were present.
Conclusion: Premenopausal women with ST-elevation myocardial infarction are on a rise in the current era, unlike previously thought. The previous studies were of comparative studies between premenopausal and postmenopausal women. Studies about the risk factors among this age group were very less. Although conventional risk factors such as diabetes and dyslipidemia played major role, some of the unusual risk factors and unidentified risk factors were found to contribute to the disease. Further studies are needed to identify the unusual risk factors for CAD present in this age group