title: Acute coronary syndrome in young women under 55 years of age: clinical characteristics, treatment, and outcomes.
abstract: BACKGROUND
  Young women with acute coronary syndrome (ACS) may represent a high risk group, but little is known about specific age and sex differences in clinical characteristics, treatment, outcomes, and trends over time.
  
  
  METHODS
  Data from 3237 men and women admitted with an ACS event from 1999 to 2006 were analyzed. Patients were grouped by sex and age less than 55 years. Demographics, presentation, treatment, and outcomes at 6 months were analyzed. Primary outcomes included mortality, recurrent myocardial infarction, rehospitalization, and stroke at 6 months. Secondary analyses assessed risk factors, management, and trends over time.
  
  
  RESULTS
  Women under 55 years represented 8% of the entire cohort, and 26% of patients under age 55 years. Compared to older women, young women were more likely to be smokers (51 vs. 14%, p < 0.001) and obese (44 vs. 34%, p = 0.006). Young women had more diabetes and hypertension than young men. Mortality was lowest among young women and did not change over time. Young women received less treatment with aspirin, beta blockers, lipid-lowering agents, and ACE inhibitors, and underwent less coronary angiography and stenting than young men (44 vs. 59%, p < 0.001). Rehospitalization was higher among young women than young men (37 vs. 27%, p < 0.001), with no change over time.
  
  
  CONCLUSIONS
  Modifiable risk factors such as smoking, obesity, diabetes, and hypertension should be addressed in young women. Following ACS, young women received fewer evidence-based medications, were treated less invasively, and had higher readmission rates within 6 months compared to young men.
authors: Division of Cardiovascular Medicine, University of Michigan, 1500 E. Medical Center Drive, SPC 5853, Ann Arbor, MI, 48109-5853, USA, davismb@med.umich.edu.
authors: Melinda
authors: M
authors: Davis
authors: Jamie
authors: J
authors: Diamond
authors: Daniel
authors: D
authors: Montgomery
authors: Sangeetha
authors: S
authors: Krishnan
authors: Kim
authors: K
authors: Eagle
authors: Elizabeth
authors: E
authors: Jackson
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D010359:Patient Readmission; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D020521:Stroke / Q000175:diagnosis / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult