Korean J Med.  2016 Oct;91(2):158-165. 10.3904/kjm.2016.91.2.158.

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

• Oh MS
• Jeong MH
• Lee SH
• Rhee JA
• Choi JS
• Park IH
• Kim C
• Kim EJ
• Kook HY
• Lee KH
• Sim DS
• Kim KH
• Hong YJ
• Park HW
• Kim JH
• Ahn YK
• Cho JG
• Park JC
• Kim SH

• KMID: 2357432
• DOI: http://doi.org/10.3904/kjm.2016.91.2.158

Abstract

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.

Keyword

Menopause; Myocardial infarction; Prognosis

MeSH Terms

Atrial Fibrillation
Diabetes Mellitus
Dyslipidemias
Female*
Follow-Up Studies
Humans
Hypertension
Incidence
Lipid Metabolism
Menopause
Myocardial Infarction*
Obesity
Premenopause
Prognosis
Risk Factors
Smoke
Smoking
Smoke