Prospective study in young women presenting acute MYOCARDIAL infarction in France: Clinical, morphological and biological descriptive analysis: WAMIF Study

Background However, women younger than 50 years accounted for 11% of MI admitted in hospital and their incidence is increasing. Purpose The main objective of this study is to systematically collect and describe clinical, morphological and biological characteristics, in hospital mortality and 12 months outcomes. Methods and Results We performed a clinical prospective observational multicenter study including all female patients admitted for MI under the age of 50. Three hundred and fourteen patients were included in twenty-eight participating centers. Mean age was 42.9 (±5.7) years old. One hundred and ninety two presented with ST elevation MI and One hundred and twenty two with non ST elevation MI. A total of 75% were active smokers, 14.6% had diabetes, 26.4% high blood pressure but only 15.3% with antihypertensive therapy, 35% had a family history of cardiovascular disease. Their specific risk factor included 33% of prior complication of pregnancy, 45.5% were under hormonal contraception 15.6% were already menopaused. Among STEMI patient 90.6% presented with typical chest pain and 58.9% reported also associated symptoms (nausea, vomiting, asthenia, sweats, dizziness or palpitation). A total of 10.4% reported prior symptoms for more than 1 week before. At admission, 13% presented with cardiac arrest. Interestingly, for STEMI patients, pre-hospital antiplatelet drugs were not systematically administered. At angiography, normal coronary angiogram was found in 6.8% of STEMI and 10.7% of NSTEMI. 29.6% of the patients included had significant multivessel disease despite their young age. Spontaneous coronary artery dissection was reported in 14.6% of STEMI and 20.5% of NSTEMI. No death, but 3 strokes, 3 recurrences of MI and 1 serious bleeding occurred during the hospitalization. Conclusion A comprehensive and systematized analysis of MI in young woman would improve our understanding and enable physician to offer patients a more appropriate therapeutic and monitoring.