Clinical profile of premenopausal female patients with coronary artery disease

Authors

  • Unnikrishnan Kartha T. D. Department of Medicine, Government T. D. Medical college, Alappuzha, Kerala, South India
  • Ambili N. R. Department of Medicine, Government T. D. Medical college, Alappuzha, Kerala, South India
  • Donna Mathew Department of Medicine, Government T. D. Medical college, Alappuzha, Kerala, South India
  • Renymol B. Department of Medicine, Government T. D. Medical college, Alappuzha, Kerala, South India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20182430

Keywords:

Coronary artery disease, Premenopausal women

Abstract

Background: Coronary artery disease is becoming the leading cause of death in the world. The incidence of CAD in females has increased rapidly in the past decades. This study aimed to analyze the clinical profile of premenopausal women with CAD and elucidate on the possible risk factors.

Methods: Premenopausal female patients admitted with an acute coronary syndrome as diagnosed by history, ECG and laboratory tests were recruited. Clinical and biochemical parameters were recorded.

Results: Mean age of study participants was 41.6±8.18 yrs. Unstable angina (60%) was the most common clinical presentation. Proportion of women with various risk factors of CAD in our study population were as follows dyslipidemia (65%), family history of premature CAD (57.5%), hypertension (55%), diabetes mellitus (42.5%), hypothyroidism (40%), PAD (37.5%), CKD (35%) and SLE (20%). Most (95%) of the study population had high LDL-c. Three fourth (77.5%) of the study population had low HDL Approximately half of the study population had fatty liver on ultrasonography. Triglyceridemia was found in 72.5% of the study population.

Conclusions: Premature CAD is increasingly evident in young premenopausal women in India. Premenopausal CAD in India is of multi factorial causation and dyslipidemia, hypertension, diabetes mellitus, central obesity and family history of premature CAD play a crucial role in its development.

Metrics

Metrics Loading ...

References

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006 Nov;3:e442.

Murray CJL, lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability from disease, injuries and risk factors in 1990 and projected to 2020. Boston, Ma: Harvard University Press;1996.

World Health Organization. The World Health Report. Making a difference. Geneva: World Health Organization;1999.

Popkin BM. The nutrition transition and its health implication in lower-income countries. Public Health Nutr. 1995;1:5-21.

Centers for Disease Control and Prevention. State-specific mortality from sudden cardiac death-United States;1999.

Rosamond W. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2007 update: a report from the American heart association statistics committee and stroke statistics subcommittee. Circulation. 2007;115:e69-171.

Shaw LJ, Shaw RE, Merz CN, Brindis RG, Klein LW, Nallamothu B, et al. Impact of ethnicity and gender differences on angiographic coronary artery disease prevalence and in-hospital mortality in the American College of Cardiology-National Cardiovascular Data Registry. Circulation. 2008 Apr 8;117(14):1787-801.

Murphy SL. Deaths: final data for 1998. National vital statistics reports. 2000 Jul 24;48(11):n11.

Ni H, Coady S, Rosamond W, Folsom AR, Chambless L, Russell SD, et al. Trends from 1987 to 2004 in sudden death due to coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study. Am Heart J. 2009 Jan 1;157(1):46-52.

Yusuf S, Hawken S, Ounpuu S. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case‐control study. J Cardiopul Rehabilitation Prevention. 2005 Jan 1;25(1):56-7.

Kam R, Cutter J, Chew SK, Tan A, Emmanuel S, Mak KH, et al. Gender differences in outcome after an acute myocardial infarction in Singapore. Singapore medical J. 2002 May;43(5):243-8.

Jenkins JS, Flaker GC, Nolte B, Price LA, Morris D, Kurz J, Petroski GF. Causes of higher in-hospital mortality in women than in men after acute myocardial infarction. Am J Cardiol. 1994 Feb 15;73(5):319-22.

Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Jama. 2003 Jan 1;289(1):76-9.

Shaw U, Bairey Merz CN, Reis SE. Ischemic heart disease in women: insights from the HLBl sponsored Women's Ischemia syndrome evaluation (WISE) study. Part I: sex differences in traditional and novel risk factors, symptom evaluation and gender-optimized diagnostic strategies. J Am Coli Cardiol. 2006;47:54-20.

Centers for Disease Control and Prevention. State-specific mortality from sudden cardiac death-United States;1999.

Lerner OJ, Kannel WB. Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population. Am Heart J. 1986;111:383-90.

Ogden CL, Carroll MD, Curtin lR, McDowell MA, Tabak CJ, Flegal KM. Prevalence'of overweight and obesity in the United States, 1999-2004. JAMA. 2006;295:549-55.

McTigue K, Larson JC, Valoski A, Burke G, Kotchen J, Lewis CE, et al. Mortality and cardiac and vascular outcomes in extremely obese women. JAMA. 2006 Jul 5;296(1):79-86.

Hokanson JE, Austin MA. Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein level: a metaanalysis of population-based prospective studies. J Cardiovasc Risk. 1996;3:213-9.

Kanaya AM, Grady D, Barrett-Connor E. Explaining the sex difference in coronary heart disease mortality among patients with type 2 diabetes mellitus: a meta-analysis. Arch Intern Med. 2002;162:1737.

Spencer EA, Pirie KL, Stevens RJ, Beral V, Brown A, Liu B, et al. Diabetes and modifiable risk factors for cardiovascular disease: the prospective Million Women Study. Euro J Epidemiol. 2008 Dec 1;23(12):793.

Gregg EW, Gu Q, Cheng YJ, Narayan KM, Cowie Cc. Mortality trends in men and women with diabetes. Ann Intern Med. 2007;147:149-55.

Daviglus ML, Stamler J, Pirzada A, Yan LL, Garside DB, Liu K, et al. Favorable cardiovascular risk profile in young women and long-term risk of cardiovascular and all-cause mortality. JAMA. 2004 Oct 6;292(13):1588-92.

Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002 Dec 4;288(21):2709-16.

Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002 Jan 16;287(3):356-9.

Pilote L, Dasgupta K, Guru V, Humphries KH, McGrath J, Norris C, et al. A comprehensive view of sex-specific issues related to cardiovascular disease. Canadian Medical Association J. 2007 Mar 13;176(6):S1-44.

Albert CM, McGovern BA, Newell JB, Ruskin JN. Sex differences in cardiac arrest survivors. Circulation. 1996 Mar 15;93(6):1170-6.

Nitenberg A, Valensi P, Sachs R, Dali M, Aptecar E, Attali JR. Impairment of coronary vascular reserve and ACh-induced coronary vasodilation in diabetic patients with angiographically normal coronary arteries and normal left ventricular systolic function. Diabetes. 1993 Jul 1;42(7):1017-25.

Hamaguchi M, Kojima T, Takeda N, Nagata C, Takeda J, Sarui H, et al. Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease. World J gastroenterology: WJG. 2007 Mar 14;13(10):1579.

Panwar RB, Gupta R, Gupta BK, Raja S, Vaishnav J, Khatri M, Agrawal A. Atherothrombotic risk factors & premature coronary heart disease in India: a case-control study. Ind J Med Res. 2011 Jul;134(1):26.

Kumra VI, Markoff BA. Who's smoking now? The epidemiology of tobacco use in the United States and abroad. Clin Chest Med. 2000;21:1-9.

Palmer JR, Rosenberg L, Shapiro S. Low yield cigarettes and the risk of non-fatal myocardial infarction in women. N Engl J Med. 1989;320:1569-73.

Downloads

Published

2018-06-25

How to Cite

T. D., U. K., N. R., A., Mathew, D., & B., R. (2018). Clinical profile of premenopausal female patients with coronary artery disease. International Journal of Research in Medical Sciences, 6(7), 2285–2290. https://doi.org/10.18203/2320-6012.ijrms20182430

Issue

Section

Original Research Articles