Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12188/33286
Title: Acute Coronary Syndrome: The Risk to Young Women
Authors: Ricci, Beatrice
Cenko, Edina
Vasiljevic, Zorana
Stankovic, Goran
Kedev, Sashko 
Kalpak, Oliver 
Vavlukis, Marija 
Zdravkovic, Marija
Hinic, Sasa
Milicic, Davor
Manfrini, Olivia
Badimon, Lina
Bugiardini, Raffaele
Issue Date: 22-Dec-2017
Publisher: Wiley-Blackwell
Journal: Journal of the American Heart Association
Abstract: Background Although acute coronary syndrome (ACS) mainly occurs in patients >50 years, younger patients can be affected as well. We used an age cutoff of 45 years to investigate clinical characteristics and outcomes of “young” patients with ACS. Methods and Results Between October 2010 and April 2016, 14 931 patients with ACS were enrolled in the ISACS‐TC (International Survey of Acute Coronary Syndromes in Transitional Countries) registry. Of these patients, 1182 (8%) were aged ≤45 years (mean age, 40.3 years; 15.8% were women). The primary end point was 30‐day all‐cause mortality. Percentage diameter stenosis of ≤50% was defined as insignificant coronary disease. ST‐segment–elevation myocardial infarction was the most common clinical manifestation of ACS in the young cases (68% versus 59.6%). Young patients had a higher incidence of insignificant coronary artery disease (11.4% versus 10.1%) and lesser extent of significant disease (single vessel, 62.7% versus 46.6%). The incidence of 30‐day death was 1.3% versus 6.9% for the young and older patients, respectively. After correction for baseline and clinical differences, age ≤45 years was a predictor of survival in men (odds ratio, 0.24; 95% confidence interval, 0.10–0.58), but not in women (odds ratio, 1.35; 95% confidence interval, 0.50–3.62). This pattern of reversed risk among sexes held true after multivariable correction for in‐hospital medications and reperfusion therapy. Moreover, younger women had worse outcomes than men of a similar age (odds ratio, 6.03; 95% confidence interval, 2.07–17.53). Conclusion ACS at a young age is characterized by less severe coronary disease and high prevalence of ST‐segment–elevation myocardial infarction. Women have higher mortality than men. Young age is an independent predictor of lower 30‐day mortality in men, but not in women.
URI: http://hdl.handle.net/20.500.12188/33286
DOI: 10.1161/JAHA.117.007519
Appears in Collections:Faculty of Medicine: Journal Articles

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