Myocardial infarction in young women is rare. it has a poorer prognosis with more complications and an excess mortality in the acute phase compared to MI in young men. Purpose to study the prognostic features of MI in young women.
We carried out a prospective study including young women whose age is ≤55 years and young men whose age is ≤45 years hospitalized for MI in the cardiology department of the CHU Constantine (Algeria) from January 2013 to March 2016. We compared the complications occurring in the acute phase and one year of the event between the 2 groups.
Out of 200 MI hospitalized patients, 30.5% were women, with an average age of 48 years. They had more clinical atypia in 34.4% of cases P=NS, more NSTEMI P=NS, had an average of 3 risk factors compared to 2 in men and had more significant coronary lesions. The reperfusion treatment was prescribed with no significant difference in the 2 groups but with a significantly longer mean delay in women. The initial complications were more frequent in women but without significant difference, heart failure 3.3% vs. 1.4%, conductive disorders 11.5% vs. 8.6%, excitability disorders 3.3% vs. 1.4% and embolic complications 4.9% vs. 0%. Hospital complications were significantly frequent in women 32.8% against 20.1%; P=0.04. With more heart failure 11.5% vs. 6.5%, more excitability disorders 3.3% vs. 1.4%, more conductive disorders 8.2% vs. 2.1%, more thromboembolic complications 3.3% vs. 0% and more LV dysfunction24.6% vs. 18%. Hospital mortality was 4 times more frequent in women 9.8% than men 2.2%; P=0.02. One year from the initial event, the number of events decreased and tended to be the same for both sexes 7.1% for women versus 8.7% for men. The death rate decreased also 2.4% versus 1.8%.
MI in young women has a worse prognosis in the acute phase with excess mortality probably related to more clinical atypia, delayed consultation and severe coronary lesions.
Le texte complet de cet article est disponible en PDF.
Publié par Elsevier Masson SAS.