Salik Ur Rehman Iqbal1
1Aga Khan University Hospital, Karachi, Pakistan
Studies show that young women with STEMI fare worse than men. Limited data exists for such patients, in particular for South Asians. : This study gaged common risk factors, angiographic features and outcomes in these patients.
It was a retrospective study done from 2013-2019 on female STEMI patients <45 years undergoing urgent Coronary Catheterization and revascularization at Aga Khan Hospital, Pakistan. Patients with prior MI or revascularization were excluded. Details of risk factors, Coronary lesions and outcomes were noted
There were total 23 subjects. Median age was 41. Mean BMI was 27.4 (+5.1) kg/m2 with 50% of patients with BMI >27 kg/m2. Seventy-four percent patients had elevated sugars and of those, 53% had uncontrolled diabetes. LDL was elevated in majority. Positive family history was seen in one-fourth, Hypertension in 8 patients and smoking in none. Eighty-two percent (n=19) patients had Single vessel disease. Of these, 73.9% (n=17) had lesion in Left anterior descending (LAD)/Diagonal artery. Right coronary/ Posterior descending artery was involved in 30.4% (n=7) cases and Left circumflex/Obtuse Marginal was involved in 21.7% (n=5) patients. Proximal LAD lesions required stents 27.6 (+10) mm long and 3.0 (+0.4) mm wide on average. Mid or distal LAD lesions required stents as long as 21.7 (+4.7) mm or as wide as 2.4 (+0.3) mm. Mortality was seen in one patient as was temporary pacing, Intubation, Cardio-pulmonary resuscitation and stroke. Two patients had heart failure and cardiogenic shock.
Almost two-third young female STEMI patients had elevated sugars followed by high risk BMI. Three-fourths had Single vessel disease. Commonest culprit vessel was LAD with Proximal LAD being most common site. Longer stents were usually required for treatment representing longer lesion length.