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KMID : 0882420160910020158
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Korean Journal of Medicine
2016 Volume.91 No. 2 p.158 ~ p.165
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Impact of Age on Clinical Outcomes in Middle-aged Korean Female Patients with Acute Myocardial Infarction - Based on a Cut-off Age of 55 Years
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Oh Mi-Sook
Jeong Myung-Ho
Lee Seung-Hun
Rhee Jung-Ae
Choi Jin-Su
Park In-Hyae
Kim Chung
Kim Eun-Jeong
Koo Hyun-Yi
Lee Ki-Hong
Sim Doo-Sun
Kim Kye-Hun
Hong Young-Joon
Park Hyung-Wook
Kim Ju-Han
Ahn Young-Keun
Cho Jeong-Gwan
Park Jong-Chun
Kim Sang-Hyung
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Abstract
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Background/Aims: It is well known that the menopause is related to interference in lipid metabolism, obesity, and a hypercoagulable state. The aim of the present study was to examine the impact of the menopause in middle-aged Korean females with acute myocardial infarction (AMI).
Methods: A total of 1,781 middle-aged females (aged < 65 years) in the Korean Acute Myocardial Infarction registry were enrolled into this study between November 2005 and December 2013. The patients were divided into two groups; the pre-menopause group (≤ 55 years old) and the menopause group (56-64 years old). Major adverse cardiac events (MACE) were analyzed over a one-year follow-up period.
Results: The pre-menopause and menopause groups comprised 669 patients (mean age, 49.1 ± 5.6 years) and 1,112 patients (mean age, 60.6 ± 2.6 years), respectively. The incidence of hypertension (42.2% vs. 59.4%, p < 0.001), diabetes mellitus (DM) (27.4% vs. 35.7%, p < 0.001), and dyslipidemia (12.9% vs. 17.7%, p = 0.008) were more frequent in menopausal patients. Additionally, the rates of smoking (20% vs. 12.7%, p < 0.001) and familial history (12% vs. 6.8%, p < 0.001) were higher in the pre-menopause group. The cumulative rates of MACE did not show any differences between the two groups. A history of atrial fibrillation, previous AMI and DM, higher Killip class, and multi-vessel disease were independent risk factors for predicting one-year MACE.
Conclusions: The survival analysis demonstrated that there was no significant difference in MACE rates between the pre-menopause and menopause groups during the one-year follow-up. Therefore, middle-aged pre-menopausal women should be treated more intensively, regardless of whether they are menopausal.
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KEYWORD
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Menopause, Myocardial infarction, Prognosis
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