Coronary artery disease in young women: risk factor analysis and long-term follow-up

BACKGROUND Heart disease is the leading cause of death in women of all ages in the United States, but data on coronary disease in young women remains sparse.

OBJECTIVE To identify and follow up a cohort of young women referred for the evaluation of coronary disease.

METHODS Retrospective review of the medical records.

RESULTS Thirty-two women younger than 31 years met the entry criteria. The average age was 28 ± 2.4 years, 28% had insulin-dependent diabetes mellitus, 38% had hypertension, 6% had congenital heart disease, 38% had a family history of coronary artery disease, 72% were smokers, and 28% used oral contraceptives. Serum cholesterol levels were >5.17 mmol/L (200 mg/dL) in 71%, and the mean cholesterol level was 6.70 ± 2 mmol/L (259 ± 78 mg/dL). Resting electrocardiographic results were abnormal in 28 women (88%), 22 of whom had evidence of transmural myocardial infarction. Follow-up averaged 9.8 ± 6.4 years. Five patients died, all of whom had hypertension, and 4 of whom had diabetic nephropathy and required dialysis.

CONCLUSIONS Risk factors for coronary disease in young women include hypertension, hypercholesterolemia, diabetes mellitus, familial coronary disease, and smoking. Long-term prognosis is excellent for those without advanced diabetes mellitus and renal failure.