Clinical characteristics and prognosis of acute coronary syndrome in young women and men: A systematic review and meta-analysis of prospective studies

Abstract

Objectives: The clinical characteristics and prognosis of young women (≤50years) with acute coronary syndrome (ACS) are still unclear.

Methods: A total of 5196 patients with ACS were enrolled from the cardiac center of Chinese PLA General Hospital and Anzhen Hospital. The clinical characteristics of these patients were analyzed. Then the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials electronic databases were searched from January 2001 to July 2016. Clinical trials that performed comparisons prognosis of young women versus men with ACS were considered for inclusion.

Results: The young men had higher BMI, had increased incidence of hyperlipidemia, and were more likely to smoke, drink alcohol, and have had a previous MI. There was a higher proportion of unstable angina (UA) in women than in men (P<0.05). The proportion of thrombolysis myocardial infarction (TIMI) 0 in women was lower than in men (P=0.001), and the proportion of TIMI 3 was higher in women than in men (P=0.000). The mortality of in-hospital, short-term, and long-term rate was significantly higher in women than that in men (6.2% vs 2.9%, OR=1.84, P<0.001; 16.4% vs 11.5%, OR=1.66, P=0.007; 8.9% vs 3.0%, OR=1.41, P=0.008), but there were no significant differences in the rates of major adverse cardiac events (MACE).

Conclusions: In young women patients with ACS, the mortality rate during in-hospital, short-term, and longer-term follow-up in women was higher than that in men. Thus, young women with ACS need more attention during clinical diagnosis and treatment.

Keywords: Acute coronary syndrome; Meta-analysis; Prognosis; Women; Young.