Clinical Characteristics, Angiographic Profile, and Hospital Outcomes of Acute Coronary Syndrome in Women Less than 55 Years of Age in a Tertiary Care Hospital of Northern Kerala

Despite the fact that the incidence of cardiovascular disease is more pronounced in women, there is a lack of evidence‑based studies that investigate the characteristics of acute coronary syndrome (ACS) in Indian women.

The study aimed to assess the clinical characteristics, angiographic profile, and hospital outcomes of ACS in women <55 years of age in a tertiary care hospital of Northern Kerala.

This was an observational study. In total, 179 women with <55 years of age, who had experienced the first episode of ACS were included in the study. Baseline characteristics including demography, risk factor, clinical presentation, and therapeutic management were reported.

Out of 179 female patients, 102 (57%) patients were postmenopausal. The most common risk factors of ACS in our population were found to be dyslipidemia (64.80%), followed by diabetes mellitus (58.10%) and hypertension (41.34%). The most frequent clinical presentation of ACS was non-ST-elevation myocardial infarction (STEMI) (49.16%), followed by STEMI (26.26%) and unstable angina (24.58%). Regarding the severity of disease, single-vessel disease (32%) was more common, followed by double-vessel disease (28%) and triple-vessel disease (24%). Left anterior descending artery (116 patients) was the most frequently involved artery in female patients, followed by right coronary artery (72 patients). Postprocedure complications associated with the study were as follows: hematoma (two patients), pseudoaneurysm (one patient), and takotsubo cardiomyopathy (one patient). Deaths were reported in two patients.

The epidemiological trend of ACS, especially in the postmenopausal women, has been continuously rising in developing countries including India. Hence, more emphasis should be given on the identification of risk factors, clinical presentation, and diagnosis in this vulnerable group, which is ultimately beneficial for therapeutic management as well as reduces mortality and morbidity.