Author + information
- Christopher Sciria,
- Rachel Dreyer,
- Basmah Safdar,
- Gail D'Onofrio,
- Harlan Krumholz and
- Erica Spatz
Background: Acute myocardial infarctions (AMI) in young women is a heterogeneous disease, with implications for diagnosis and treatment; yet data are limited. We aimed to characterize mechanisms of AMI and inpatient practice patterns among women aged ≤55 years presenting to a large urban hospital system with a clinical diagnosis of AMI from 2011 to 2016.
Methods: We conducted a medical chart review of consecutive eligible patients with a primary or secondary discharge diagnosis of AMI (ICD9 code =410.xx) who underwent cardiac catheterization during hospitalization. We classified women based on catheterization findings and assessed discharge medications as a signal of assumed disease mechanism.
Results: Among 140 women, 27% had no evidence of critical stenosis/thrombosis (Table). Only 5 women had other defined mechanisms (vasospasm, dissection); the remainder had no explanatory findings based on cardiac catheterization. Medications on discharge varied across and within disease mechanisms.
Conclusions: One in four young women with AMI do not exhibit classic findings of critical stenosis/thrombosis. Among this group, revascularization patterns and discharge medications varied. These data validate prior findings from large cohort studies demonstrating heterogeneity in presentation and treatment of young women with AMI, and underscore the need for more nuanced classification systems to guide research and clinical practice that is specific to the range of phenotypes of AMI in young women.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Cardiac Arrest, Diabetes, and Other High Risk Features of Patients With Acute Coronary Syndrome
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1204-349
- 2017 American College of Cardiology Foundation