Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2020

Open Access 01-12-2020 | Coronary Heart Disease | Research article

The characteristics of risk factors in Chinese young women with acute coronary syndrome

Authors: Ruifang Liu, Fangxing Xu, Yujie Zhou, Tongku Liu

Published in: BMC Cardiovascular Disorders | Issue 1/2020

Login to get access

Abstract

Background

In recent years, the prevalence rate of acute coronary syndrome (ACS) in Chinese young women has been increasing significantly, becoming one of the main causes of death in young females. A matter of constant concern is what is the characteristics and differences in risk factors between young women with ACS and without ACS. This study aimed to investigate the characteristics and difference of risk factors in Chinese young women with ACS and to provide references for ACS prevention and treatment.

Methods

A 1:1 case-control study was conducted to evaluate risk factors of 415 young females with ACS (ACS group) who underwent PCI treatment and 415 young females without ACS (control group) who were hospitalized and confirmed by coronary angiography to exclude coronary heart disease from January 2010 to August 2016. The average age of the cases in groups was respectively (40.77 ± 4.02) and (40.57 ± 4.01) years-old (P > 0.05).

Results

The risk factors in ACS group were overweight (64.10%), hypertension (49.88%), hyperlipidemia (40.72%), diabetes (23.37%), depression or anxiety (16.63%), gynecological diseases (16.39%), Hyperuricemia (14.94%), family history of early-onset CHD (14.94%), hyperhomocysteinemia (11.33%), hypothyroidism (9.64%), hypercholesterolemia (8.43%) and high C-reactive protein (7.47%), and were significant difference (P < 0.01) compared with that of the control group. The average number of risk factors per case in ACS group was significantly more than that of control groups (P < 0.01). Regression analysis showed that hyperlipidemia, hyperhomocysteinemia, overweight (obesity), high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early-onset CHD, and autoimmune diseases were independent risk factors (P < 0.01). The bivariate correlation analysis between CRP level and age was r = − 0.158 (P < 0.01). The result showed the younger ACS patient is the higher serum CRP.

Conclusion

The independent risk factors of ACS in young women are hyperlipidemia, hyperhomocysteinemia, overweight, high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early-onset CHD, and autoimmune diseases. The co-existence of multiple risk factors is the main cause suffering from ACS in young women.
Appendix
Available only for authorised users
Literature
1.
go back to reference He J, Gu D, Wu X, Reynolds K, Duan XF, Yao CH, et al. Major causes of death among men and women in China. N Engl J Med. 2005;353(11):1124–34.CrossRefPubMed He J, Gu D, Wu X, Reynolds K, Duan XF, Yao CH, et al. Major causes of death among men and women in China. N Engl J Med. 2005;353(11):1124–34.CrossRefPubMed
2.
go back to reference Chandrasekhar J, Gill A, Mehran R. Acute myocardial infarction in young women: current perspectives. Int J Women's Health. 2018;10:267–84.CrossRef Chandrasekhar J, Gill A, Mehran R. Acute myocardial infarction in young women: current perspectives. Int J Women's Health. 2018;10:267–84.CrossRef
3.
go back to reference Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation. 2020;141:e139–596.PubMed Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation. 2020;141:e139–596.PubMed
4.
go back to reference Hua D, Yu D. Epidemiology of cardiovascular disease in Asian women, Nutrition. Metab Cardiovasc Dis. 2010;20:394–404.CrossRef Hua D, Yu D. Epidemiology of cardiovascular disease in Asian women, Nutrition. Metab Cardiovasc Dis. 2010;20:394–404.CrossRef
5.
go back to reference Wang X, Gao M, Zhou SS, Wang JW, Liu F, Tian F, et al. Trend in young coronary artery disease in China from 2010 to 2014: a retrospective study of young patients≤ 45. BMC Cardiovasc Disord. 2017;17(18):1–8.PubMedPubMedCentral Wang X, Gao M, Zhou SS, Wang JW, Liu F, Tian F, et al. Trend in young coronary artery disease in China from 2010 to 2014: a retrospective study of young patients≤ 45. BMC Cardiovasc Disord. 2017;17(18):1–8.PubMedPubMedCentral
6.
go back to reference O'Gara PT, Kushne FG, Ascheim DD, CaseyJr DE, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2013;61(4):e78–e140.CrossRefPubMed O'Gara PT, Kushne FG, Ascheim DD, CaseyJr DE, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2013;61(4):e78–e140.CrossRefPubMed
7.
go back to reference Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;130(25):2354–94.CrossRefPubMed Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;130(25):2354–94.CrossRefPubMed
8.
go back to reference Arslan F, Bongartz L, ten Berg JM, Jukema JW, Appelman Y, Liem AH, et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: comments from the Dutch ACS working group. Neth Hear J. 2018;26:417–21.CrossRef Arslan F, Bongartz L, ten Berg JM, Jukema JW, Appelman Y, Liem AH, et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: comments from the Dutch ACS working group. Neth Hear J. 2018;26:417–21.CrossRef
9.
go back to reference Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult—summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (writing committee to update the 2001 guidelines for the evaluation and management of heart failure). J Am Coll Cardiol. 2005;46(6):1116–43.CrossRef Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult—summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (writing committee to update the 2001 guidelines for the evaluation and management of heart failure). J Am Coll Cardiol. 2005;46(6):1116–43.CrossRef
10.
go back to reference Kopple JD. National Kidney Foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis. 2001;37(Suppl 2):S66–70.CrossRefPubMed Kopple JD. National Kidney Foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis. 2001;37(Suppl 2):S66–70.CrossRefPubMed
11.
go back to reference Patel JK, Hughes EA, Mackness MI, Vyas A, Cruickshank JK. Appropriate body-mass index for Asians. Lancet. 2003;361(9351):85.CrossRefPubMed Patel JK, Hughes EA, Mackness MI, Vyas A, Cruickshank JK. Appropriate body-mass index for Asians. Lancet. 2003;361(9351):85.CrossRefPubMed
12.
go back to reference Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med. 2003;139(2):137–47.CrossRefPubMed Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med. 2003;139(2):137–47.CrossRefPubMed
13.
go back to reference Braunwald E, Sabatine MS. The thrombolysis in myocardial infarction (TIMI) study group experience. J Thorac Cardiovasc Surg. 2012;144(4):762–70.CrossRefPubMed Braunwald E, Sabatine MS. The thrombolysis in myocardial infarction (TIMI) study group experience. J Thorac Cardiovasc Surg. 2012;144(4):762–70.CrossRefPubMed
14.
go back to reference Patel SA, Winkel M, Ali MK, Narayan KM, Mehta NK. Cardiovascular mortality associated with 5 leading risk factors: national and state preventable fractions estimated from survey data. Ann Intern Med. 2015;163(4):245–53.CrossRefPubMed Patel SA, Winkel M, Ali MK, Narayan KM, Mehta NK. Cardiovascular mortality associated with 5 leading risk factors: national and state preventable fractions estimated from survey data. Ann Intern Med. 2015;163(4):245–53.CrossRefPubMed
15.
go back to reference Vilahur G, Badimon JJ, Bugiardini R, Badimon L. Perspectives: The burden of cardiovascular risk factors and coronary heart disease in Europe and worldwide. Eur Heart J. 2014;16(suppl A):A7–A11.CrossRef Vilahur G, Badimon JJ, Bugiardini R, Badimon L. Perspectives: The burden of cardiovascular risk factors and coronary heart disease in Europe and worldwide. Eur Heart J. 2014;16(suppl A):A7–A11.CrossRef
16.
go back to reference Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham heart study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2014;383(9921):999–1008.CrossRefPubMed Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham heart study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2014;383(9921):999–1008.CrossRefPubMed
17.
go back to reference Andersson C, Johnson AD, Benjamin EJ, Levy D, Vasan RS. 70-year legacy of the Framingham heart study. Nat Rev Cardiol. 2019;16:687–98.CrossRefPubMed Andersson C, Johnson AD, Benjamin EJ, Levy D, Vasan RS. 70-year legacy of the Framingham heart study. Nat Rev Cardiol. 2019;16:687–98.CrossRefPubMed
19.
go back to reference Brown HL, Warner JJ, Gianos E, Gulati M, Hill AJ, Hollier LM, et al. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory from the American Heart Association and the American College of Obstetricians and Gynecologists. Circulation. 2018;137(24):e843–52.CrossRefPubMed Brown HL, Warner JJ, Gianos E, Gulati M, Hill AJ, Hollier LM, et al. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory from the American Heart Association and the American College of Obstetricians and Gynecologists. Circulation. 2018;137(24):e843–52.CrossRefPubMed
20.
go back to reference Hackshaw A, Morris JK, Boniface S. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ. 2018;363:k5035. Hackshaw A, Morris JK, Boniface S. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ. 2018;363:k5035.
21.
go back to reference Skak-Nielsen H, Torp-Pedersen C, Finer N, Caterson ID, Van Gaal L, James WPT, et al. Uric acid as a risk factor for cardiovascular disease and mortality in overweight/obese individuals. PLoS One. 2013;8(3):e59121.CrossRefPubMedPubMedCentral Skak-Nielsen H, Torp-Pedersen C, Finer N, Caterson ID, Van Gaal L, James WPT, et al. Uric acid as a risk factor for cardiovascular disease and mortality in overweight/obese individuals. PLoS One. 2013;8(3):e59121.CrossRefPubMedPubMedCentral
22.
go back to reference Venetkoski M, Savolainen-Peltonen H, Rahkola-Soisalo P, Hoti F, Vattulainen P, Gissler M, et al. Increased cardiac and stroke death risk in the first year after discontinuation of postmenopausal hormone therapy. Menopause. 2018;25(4):375–9.CrossRefPubMed Venetkoski M, Savolainen-Peltonen H, Rahkola-Soisalo P, Hoti F, Vattulainen P, Gissler M, et al. Increased cardiac and stroke death risk in the first year after discontinuation of postmenopausal hormone therapy. Menopause. 2018;25(4):375–9.CrossRefPubMed
23.
go back to reference Zhao D, Guallar E, Ouyang P, Subramanya V, Vaidya D, Ndumele CE, et al. Endogenous sex hormones and incident cardiovascular disease in post-menopausal women. J Am Coll Cardiol. 2018;71(22):2555–66.CrossRefPubMedPubMedCentral Zhao D, Guallar E, Ouyang P, Subramanya V, Vaidya D, Ndumele CE, et al. Endogenous sex hormones and incident cardiovascular disease in post-menopausal women. J Am Coll Cardiol. 2018;71(22):2555–66.CrossRefPubMedPubMedCentral
24.
go back to reference Shaw LJ, Pepine CJ, Xie J, Mehta PK, Morris AA, Dickert NW, et al. Quality and equitable health care gaps for women: attributions to sex differences in cardiovascular medicine. J Am Coll Cardiol. 2017;70(3):373–88.CrossRefPubMed Shaw LJ, Pepine CJ, Xie J, Mehta PK, Morris AA, Dickert NW, et al. Quality and equitable health care gaps for women: attributions to sex differences in cardiovascular medicine. J Am Coll Cardiol. 2017;70(3):373–88.CrossRefPubMed
25.
go back to reference Greenwood BN, Carnahan S, Huang L. Patient-physician gender concordance and increased mortality among female heart attack patients. Proc Natl Acad Sci U S A. 2018;115(34):8569–74.CrossRefPubMedPubMedCentral Greenwood BN, Carnahan S, Huang L. Patient-physician gender concordance and increased mortality among female heart attack patients. Proc Natl Acad Sci U S A. 2018;115(34):8569–74.CrossRefPubMedPubMedCentral
26.
go back to reference Liu HH, Dong Z, Ma CS, Liu XH, Lv Q, Qi Y, et al. C -reactive protein predicts the severity of coronary artery disease beyond low-density lipoprotein cholesterol. Angiology. 2012;63(3):218–22.CrossRefPubMed Liu HH, Dong Z, Ma CS, Liu XH, Lv Q, Qi Y, et al. C -reactive protein predicts the severity of coronary artery disease beyond low-density lipoprotein cholesterol. Angiology. 2012;63(3):218–22.CrossRefPubMed
27.
go back to reference He C, Lin P, Liu W, Fang K. Prognostic value of hyperuricemia in patients with acute coronary syndrome: a meta-analysis. Eur J Clin Investig. 2019;49(4):e13074.CrossRef He C, Lin P, Liu W, Fang K. Prognostic value of hyperuricemia in patients with acute coronary syndrome: a meta-analysis. Eur J Clin Investig. 2019;49(4):e13074.CrossRef
28.
go back to reference Lv S, Liu W, Zhou Y, Liu Y, Shi D, Zhao Y, et al. Hyperuricemia and smoking in young adults suspected of coronary artery disease ≤ 35 years of age: a hospital - based observational study. BMC Cardiovasc Disord. 2018;18(1):178.CrossRefPubMedPubMedCentral Lv S, Liu W, Zhou Y, Liu Y, Shi D, Zhao Y, et al. Hyperuricemia and smoking in young adults suspected of coronary artery disease ≤ 35 years of age: a hospital - based observational study. BMC Cardiovasc Disord. 2018;18(1):178.CrossRefPubMedPubMedCentral
29.
go back to reference Badimon L, Peña E, Arderiu G, Padró T, Slevin M, Vilahur G, et al. C-reactive protein in atherothrombosis and angiogenesis. Front Immunol. 2018;9(2):430–7.CrossRefPubMedPubMedCentral Badimon L, Peña E, Arderiu G, Padró T, Slevin M, Vilahur G, et al. C-reactive protein in atherothrombosis and angiogenesis. Front Immunol. 2018;9(2):430–7.CrossRefPubMedPubMedCentral
Metadata
Title
The characteristics of risk factors in Chinese young women with acute coronary syndrome
Authors
Ruifang Liu
Fangxing Xu
Yujie Zhou
Tongku Liu
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2020
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-020-01577-z

Other articles of this Issue 1/2020

BMC Cardiovascular Disorders 1/2020 Go to the issue