Age at menopause, extent of coronary artery disease and outcome among postmenopausal women with acute coronary syndromes

LADIES ACS Investigators

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Early menopause has been associated with increased cardiovascular mortality, but prospective studies investigating outcomes of postmenopausal women with acute coronary syndromes (ACS) in relation to menopausal age are lacking. Methods: We analyzed the 1-year outcome of 373 women with acute myocardial infarction enrolled in the Ladies ACS study. All patients underwent coronary angiography, with corelab analysis. Menopause questionnaires were administered during admission. Menopausal age below the median of the study population (50 years) was defined as “early menopause”. The composite 1-year outcome included all-cause mortality, recurrent myocardial infarction and stroke. Results: The mean age at index ACS was 73 years (IQR 65–83) for women with early menopause, and 74 (IQR 65–80) for those with late menopause. Patients with early menopause had more prevalent chronic kidney disease (12.8% vs 5.9%, p = 0.03), whereas there were no differences in all other clinical characteristics, extent of coronary disease at angiography (as assessed by Gensini and SYNTAX scores), as well as interventional treatments. Within 1 year, women with late menopause had significantly better outcome as compared with those with early menopause (6.5% vs 15.3%, p = 0.007). At logistic regression analysis, late menopause was independently associated with better outcome (OR 0.28; 95% CI 0.12–0.67; p = 0.004). With each year's delay in the menopause the adjusted risk decreased by 12% (OR 0.88, 0.77–0.99, p = 0.040). Conclusion: Despite comparable clinical and angiographic characteristics, women with late menopausal age experience better outcomes after an ACS as compared with those with early menopause.

Original languageEnglish
Pages (from-to)8-13
Number of pages6
JournalInternational Journal of Cardiology
Volume259
DOIs
Publication statusPublished - May 15 2018

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Acute Coronary Syndrome
Menopause
Coronary Artery Disease
Myocardial Infarction
Mortality
Coronary Angiography
Chronic Renal Insufficiency
Coronary Disease
Angiography
Logistic Models
Stroke
Regression Analysis
Prospective Studies

Keywords

  • Acute coronary syndromes
  • Coronary angiography
  • Menopause
  • Outcome
  • Sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Age at menopause, extent of coronary artery disease and outcome among postmenopausal women with acute coronary syndromes. / LADIES ACS Investigators.

In: International Journal of Cardiology, Vol. 259, 15.05.2018, p. 8-13.

Research output: Contribution to journalArticle

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title = "Age at menopause, extent of coronary artery disease and outcome among postmenopausal women with acute coronary syndromes",
abstract = "Background: Early menopause has been associated with increased cardiovascular mortality, but prospective studies investigating outcomes of postmenopausal women with acute coronary syndromes (ACS) in relation to menopausal age are lacking. Methods: We analyzed the 1-year outcome of 373 women with acute myocardial infarction enrolled in the Ladies ACS study. All patients underwent coronary angiography, with corelab analysis. Menopause questionnaires were administered during admission. Menopausal age below the median of the study population (50 years) was defined as “early menopause”. The composite 1-year outcome included all-cause mortality, recurrent myocardial infarction and stroke. Results: The mean age at index ACS was 73 years (IQR 65–83) for women with early menopause, and 74 (IQR 65–80) for those with late menopause. Patients with early menopause had more prevalent chronic kidney disease (12.8{\%} vs 5.9{\%}, p = 0.03), whereas there were no differences in all other clinical characteristics, extent of coronary disease at angiography (as assessed by Gensini and SYNTAX scores), as well as interventional treatments. Within 1 year, women with late menopause had significantly better outcome as compared with those with early menopause (6.5{\%} vs 15.3{\%}, p = 0.007). At logistic regression analysis, late menopause was independently associated with better outcome (OR 0.28; 95{\%} CI 0.12–0.67; p = 0.004). With each year's delay in the menopause the adjusted risk decreased by 12{\%} (OR 0.88, 0.77–0.99, p = 0.040). Conclusion: Despite comparable clinical and angiographic characteristics, women with late menopausal age experience better outcomes after an ACS as compared with those with early menopause.",
keywords = "Acute coronary syndromes, Coronary angiography, Menopause, Outcome, Sex",
author = "{LADIES ACS Investigators} and Stefano Savonitto and Nuccia Morici and Nicoletta Franco and Leonardo Misuraca and Laura Lenatti and Ferri, {Luca A.} and {Lo Jacono}, Emilia and Chiara Leuzzi and Elena Corrada and Aranzulla, {Tiziana C.} and Angelo Cagnacci and Delia Colombo and {La Vecchia}, Carlo and Francesco Prati",
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T1 - Age at menopause, extent of coronary artery disease and outcome among postmenopausal women with acute coronary syndromes

AU - LADIES ACS Investigators

AU - Savonitto, Stefano

AU - Morici, Nuccia

AU - Franco, Nicoletta

AU - Misuraca, Leonardo

AU - Lenatti, Laura

AU - Ferri, Luca A.

AU - Lo Jacono, Emilia

AU - Leuzzi, Chiara

AU - Corrada, Elena

AU - Aranzulla, Tiziana C.

AU - Cagnacci, Angelo

AU - Colombo, Delia

AU - La Vecchia, Carlo

AU - Prati, Francesco

PY - 2018/5/15

Y1 - 2018/5/15

N2 - Background: Early menopause has been associated with increased cardiovascular mortality, but prospective studies investigating outcomes of postmenopausal women with acute coronary syndromes (ACS) in relation to menopausal age are lacking. Methods: We analyzed the 1-year outcome of 373 women with acute myocardial infarction enrolled in the Ladies ACS study. All patients underwent coronary angiography, with corelab analysis. Menopause questionnaires were administered during admission. Menopausal age below the median of the study population (50 years) was defined as “early menopause”. The composite 1-year outcome included all-cause mortality, recurrent myocardial infarction and stroke. Results: The mean age at index ACS was 73 years (IQR 65–83) for women with early menopause, and 74 (IQR 65–80) for those with late menopause. Patients with early menopause had more prevalent chronic kidney disease (12.8% vs 5.9%, p = 0.03), whereas there were no differences in all other clinical characteristics, extent of coronary disease at angiography (as assessed by Gensini and SYNTAX scores), as well as interventional treatments. Within 1 year, women with late menopause had significantly better outcome as compared with those with early menopause (6.5% vs 15.3%, p = 0.007). At logistic regression analysis, late menopause was independently associated with better outcome (OR 0.28; 95% CI 0.12–0.67; p = 0.004). With each year's delay in the menopause the adjusted risk decreased by 12% (OR 0.88, 0.77–0.99, p = 0.040). Conclusion: Despite comparable clinical and angiographic characteristics, women with late menopausal age experience better outcomes after an ACS as compared with those with early menopause.

AB - Background: Early menopause has been associated with increased cardiovascular mortality, but prospective studies investigating outcomes of postmenopausal women with acute coronary syndromes (ACS) in relation to menopausal age are lacking. Methods: We analyzed the 1-year outcome of 373 women with acute myocardial infarction enrolled in the Ladies ACS study. All patients underwent coronary angiography, with corelab analysis. Menopause questionnaires were administered during admission. Menopausal age below the median of the study population (50 years) was defined as “early menopause”. The composite 1-year outcome included all-cause mortality, recurrent myocardial infarction and stroke. Results: The mean age at index ACS was 73 years (IQR 65–83) for women with early menopause, and 74 (IQR 65–80) for those with late menopause. Patients with early menopause had more prevalent chronic kidney disease (12.8% vs 5.9%, p = 0.03), whereas there were no differences in all other clinical characteristics, extent of coronary disease at angiography (as assessed by Gensini and SYNTAX scores), as well as interventional treatments. Within 1 year, women with late menopause had significantly better outcome as compared with those with early menopause (6.5% vs 15.3%, p = 0.007). At logistic regression analysis, late menopause was independently associated with better outcome (OR 0.28; 95% CI 0.12–0.67; p = 0.004). With each year's delay in the menopause the adjusted risk decreased by 12% (OR 0.88, 0.77–0.99, p = 0.040). Conclusion: Despite comparable clinical and angiographic characteristics, women with late menopausal age experience better outcomes after an ACS as compared with those with early menopause.

KW - Acute coronary syndromes

KW - Coronary angiography

KW - Menopause

KW - Outcome

KW - Sex

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JF - International Journal of Cardiology

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