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Coronary artery disease in young women: risk factor analysis and long-term follow-up
1Department of Cardiology, Cleveland Clinic Foundation, OH 44195.
Insights
Coronary artery disease is a serious concern for young women, with hypertension, diabetes, and smoking being significant risk factors. Early identification and management are crucial for better long-term outcomes.
Area of Science:
- Cardiology
- Women's Health
- Epidemiology
Background:
- Heart disease is the leading cause of death for women in the U.S.
- Data on coronary artery disease (CAD) in young women is limited.
- This study focuses on young women referred for CAD evaluation.
Purpose of the Study:
- To identify and follow a cohort of young women experiencing coronary artery disease.
- To analyze risk factors and outcomes in this demographic.
Main Methods:
- Retrospective review of medical records.
- Inclusion criteria: women younger than 31 years referred for CAD evaluation.
Main Results:
- 32 women (average age 28) were included.
- High prevalence of risk factors: 72% smokers, 38% hypertension, 28% diabetes mellitus, 71% hypercholesterolemia.
- 88% had abnormal ECGs, with 22 showing myocardial infarction.
- Five-year follow-up revealed 5 deaths, all with hypertension; 4 also had diabetic nephropathy.
Conclusions:
- Key risk factors for CAD in young women include hypertension, hypercholesterolemia, diabetes mellitus, family history, and smoking.
- Prognosis is generally good, but poor for those with advanced diabetes and renal failure.
Background:
Heart disease in the leading cause of death in women of all ages in the United States, but data on coronary disease in young women remains sparse.
Objective:
To identify and follow up a cohort of young women referred for the evaluation of coronary disease.
Methods:
Retrospective review of the medical records.
Results:
Thirty-two women younger than 31 years met the entry criteria. The average age was 28 +/- 2.4 years, 28% had insulin-dependent diabetes mellitus, 38% had hypertension, 6% had congenital heart disease, 38% had a family history of coronary artery disease, 72% were smokers, and 28% used oral contraceptives. Serum cholesterol levels were > 5.17 mmol/L (200 mg/dL) in 71%, and the mean cholesterol level was 6.70 +/- 2 mmol/L (259 +/- 78 mg/dL). Resting electrocardiographic results were abnormal in 28 women (88%), 22 of whom had evidence of transmural myocardial infarction. Follow-up averaged 9.8 +/- 6.4 years. Five patients died, all of whom had hypertension, and 4 of whom had diabetic nephropathy and required dialysis.
Conclusions:
Risk factors for coronary disease in young women include hypertension, hypercholesterolemia, diabetes mellitus, familial coronary disease, and smoking. Long-term prognosis is excellent for those without advanced diabetes mellitus and renal failure.