Abstract
Introduction: Young women (≤55 years) with acute myocardial infarction (AMI) have higher rates of mortality and morbidity than similarly aged men. An abnormal lipid profile following AMI is a risk factor for recurrent cardiovascular events and may contribute to worse outcomes in young women. However, little is known about the extent to which young women and men with AMI have similar or distinct lipid profiles after hospital discharge. We characterized sex difference in lipid phenotypes in young patients with AMI. Methods: We included 2,217 AMI patients (715 men and 1,502 women) aged 18-55 years from the VIRGO study. Standard lipid profile and lipoprotein subclasses were measured 1-month after discharge for AMI. Both sexes were compared on three dyslipidemia phenotypes: 1) increased low-density lipoprotein cholesterol (LDL-C≥100 mg/dL), 2) decreased high-density lipoprotein cholesterol (HDL-C<40 mg/dL for men, <50 mg/dL for women), and 3) increased small/medium LDL particles, decreased large HDL particles, and decreased LDL peak particle size (cutoffs based on sex-specific tertile values of healthy individuals). We also compared patient characteristics between sexes and used t-tests to assess statistical significance. Results: The median age was 48 years for both sexes. At baseline, women were more likely than men to be black, single, to have financial strain, obesity and diabetes (all P values<0.001). At 1-month after hospital discharge, women had higher rates of dyslipidemia phenotypes than men, including increased LDL-C (P=0.031, see Table) and an atherogenic phenotype characterized by multiple lipoprotein subclasses (P<0.001). The latter had the largest difference between men and women. The proportion of decreased HDL-C was similar for both sexes (P=0.300). Conclusion: Young women have higher rates of dyslipidemia phenotypes than men at 1-month after discharge for AMI. Effective interventions are needed to improve lipid control in young women with AMI.
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