Risk Factors And Clinical Characteristics Of Premenopausal Women With ST-segment Elevation Acute Myocardial Infarction

Objectives:To investigate the risk factors and clinical characteristics of premenopausal female with ST-segment elevation myocardial infarction(STEMI).Methods:1.A total of 700 patients who were admitted to our hospital from January 2013 to May 2018 and underwent coronary angiography were included in the study.Of which 141 premenopausal female(≤50 years old)with STEMI were selected as a case group(Group 1),and 152 young female patients(≤50 years old)with normal coronary angiography(Group 2),168 young(≤50 years old)male patients with STEMI(Group3),239 postmenopausal(>50 years old)female patients with STEMI(Group 4)were randomly selected as control groups who were hospitalized during the same period.2.Heart rate,blood pressure,hemoglobin(Hb),fasting blood glucose,albumin,triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),troponin,essential hypertension,type 2 diabetes mellitus,hyperlipidemia,smoking history,familial history of coronary artery disease were measured.Analyze the risk factors in premenopausal female patients with STEMI.3.Coronary angiographic characteristics were observed by coronary angiography.Analyze coronary lesions(anterior descending branch,gyroscopic branch,etc.)and the number of lesions involved(single-vessel disease,multi-vessel disease,etc.)in premenopausal female patients with STEMI.4.Analyze the occurrence of major adverse cardiovascular events during hospitalization5.Creating a database through the application of SPSS 23.0 software package for statistical analysis.The normal distribution of the measurement data wasexpressed as mean ± standard deviation(`x±s),two groups comparison used t test and multi-group comparison used analysis of variance,pairwise comparison used Bonferroni method;The non-normal distribution of measurement data with median and interquartile range(M(Q1,Q3)),the rank-sum test was used for comparison between groups.Count data was expressed as a percentage and the c2 test was used for comparison between groups.Logistic regression analysis was used to find the risk factors of premenopausal women with STEMI.The difference was statistically significant at P<0.05.Result:1.Compared with Group 2,prevalence of hypertension,diabetes,hyperlipidemia and smoking history were significantly higher,level of albumin was lower and levels of fasting blood glucose,triglycerides were higher in Group 1.The number of traditional risk factors was less in Group 1.Compared with Group 3,levels of triglyceride,albumin,troponin were significantly lower and level of high-density lipoprotein cholesterol was higher in Group 1.Compared with Group 4,prevalence of hypertension was lower in Group 1.2.Compared with Group 3,Group 1 had a longer time from onset to arrival at the hospital.3.Logistic regression analysis showed that the risk factors associated with STEMI in premenopausal women were smoking(OR=8.280),hypertension(OR=2.076),type 2 diabetes mellitus(OR=13.424).4.The number of infarct-related coronary lesions had no difference between Group 1 and Group 3.Compared with Group 3,coronary artery disease mainly involved left anterior descending artery in Group.Compared with Group 4,the proportion of single-vessel disease was higher(P<0.05),and the proportion of multi-vessel disease was lower(P<0.05)in Group 1.5.The total ratio of MACE during hospital has no difference between Group 1and Group 3,while the ratio of acute heart failure in Group 1 was higher than Group 3.Compared with Group 4,the ratio of MACE,acute heart failure and death was lower in Group 1.Conclusions:1.Smoking,hypertension,elevated fasting blood glucose and hypoalbuminemia are the independengt risk factors in premenopausal female with STEMI.And there may be other undefined risk factors in addition to this.2.Compared with young males,premenopausal females have a longer time from disease attack to arrival at the hospital.3.In premenopausal female with STEMI,coronary lesions are mainly single-vessel disease,and mainly involve the anterior descending branch.4.Premenopausal women with STEMI are tend to acute cardiac insufficiency during hospitalization compared with young men.