Premenopausal and postmenopausal women presenting with acute coronary syndrome: A comparison study of their clinical and angiographic profiles

Abstract

Context: Acute coronary syndrome (ACS) encompasses a range of conditions associated with sudden, reduced blood flow to the heart, typically due to an acute blockage of a coronary artery. The severity and specific location of the blockage determine the type of ACS and its consequences. Menopause, marked by a significant decline in estrogen levels, is known to negatively impact circulatory function and metabolism, potentially increasing the risk of ACS. However, there is a lack of studies comparing the burden of cardiovascular disease between pre- and postmenopausal women. Aim: This study seeks to bridge the knowledge gap regarding the impact of menopausal status on the presentation and severity of ACS in women. Setting and Design: This retrospective observational study was conducted in a single center, India, over 7 months. Materials and Methods: The study included 250 patient populations among which 120 were premenopausal and 130 were postmenopausal women. The subjects were evaluated for their clinical and angiographic profile. Statistical Analysis Used: Differences between pre- and postmenopausal women were compared using the two-sample t-test for continuous variables and the Chi-square test for categorical variables. Results: In this study, the mean ± standard deviation number of stenotic vessels and Gensini score was significantly higher in postmenopausal patients (2.46 ± 0.74 and 47.35 ± 20.92, respectively) than in premenopausal patients (1.30 ± 0.27 and 13.13 ± 4.43, respectively) which indicate the severity of coronary artery disease in postmenopausal women. Conclusion: Menopausal status significantly impacts the severity of coronary artery disease (CAD) in women presenting with ACS, as demonstrated by the marked difference in Gensini scores.

Keywords

• acute coronary syndrome
• estrogen
• gensini score
• pre- and postmenopausal women