Acute coronary syndrome in women – challenges and difficulties

Abstract

Introduction. Heart disease is the leading cause of hospitalization and death in elderly women. The role of conventional cardiovascular risk factors in women is incompletely understood and the manifestations of acute coronary syndrome are generally believed to be atypical in the elderly women. Purpose. To evaluate the risk factors, clinical features, outcomes in eldery women with acute coronary coronary syndrome (ACS). Material and methods. The study was based on the retrospective analysis of 78 medical records, during June-december 2018. The primary outcome of interest was major adverse cardiac events (MACE) represented by death, acute myocardial infarction, heart failure and arrhythmias. Results. 78 cases of ACS were categorized in 2 groups: (a) Group I - age < 60 years, (b) Group II - age >60 years. Data on clinical history, complications, cardiovascular risk factors and relevant clinical parameters were analyzed. Complications at onset, during hospitalization and 30 days after discharge from hospital were assessed. The MACE rate was significantly higher among the group II patients with (P<0.001)). In a multivariable analysis kidney failure at admission(OR 1.5, 95% CI 1.23-4.357) were associated with MACE among those the group II patients with ST-elevation ACS. Conclusions. This study revealed that the manifestations of ACS are more subtle in the elderly women, with different risk factors. The elderly subjects have higher complication and mortality rate. Detection and prevention of risk factors could increase life expectancy in patients with ACS.