Abstract 13866: Quantity of Cardiovascular Risk Factors and Associated Outcomes in Young Women With ST-Elevation Myocardial Infarction

Abstract

Introduction: Despite the remarkable progress in STEMI care, the mortality rates in young women with STEMI remain high. It remains unclear whether this is related to the number of cardiovascular (CV) risk factors. Methods: From 2010 to 2020, we evaluated 10,441 consecutive STEMI patients, including 3,150 (30%) women enrolled in prospective Midwest STEMI Consortium registry, constituted of Minneapolis Heart Institute, Minneapolis, MN, The Christ Hospital, Cincinnati, OH, Prairie Heart Institute, Springfield, IL, and Iowa Heart Center, Des Moines, IA. We categorized baseline CV risk factors (hypertension, dyslipidemia, diabetes, smoking, and family history of CAD) in the 477 (15%) women <55 years and without previous history of CAD. Results: Smoking was the most common, and diabetes the least common CV risk factor. Of the 477 women, 161 (33.8%) had 0 or 1 CV risk factor, 132 (27.7%) had 2, and 184 (38.6%) had at least 3 CV risk factors. As the number of CV risk factors decreased, non-atherosclerotic STEMI etiologies -SCAD or Takotsubo syndrome- increased, as did the incidences of cardiogenic shock or cardiac arrest. There were no differences in reperfusion strategies or time among patients with 0 or more CV risk factors; however, as the number of CV risk factors decreased, patients were less likely to receive antiplatelet or statin at discharge. There was a trend toward higher death in the hospital with decreasing number of CV risk factors, but it did not reach statistical significance (p=0.075) (Table). Conclusions: Young women with fewer traditional CV risk factors more often presented with non-atherosclerotic causes of STEMI and higher incidences of cardiogenic shock or cardiac arrest and had a trend toward a higher risk of in-hospital death. Thus, future epidemiological studies are needed to determine if sex-specific risk enhancers, in addition to traditional CV risk factors, have a role in risk stratification among young women for future CV events.