What are the clinical and angiographic features of the coronary artery disease in postmenopausal women

Background The menopause marks an evolutionary turning point in women's health. It is widely accepted that the risk for coronary artery disease (CAD) of premenopausal women is low because of hormone protection. CAD is the leading cause of morbidity and mortality in women after the age of 50 years. The aim of our study is to analyze the clinical and angiographic characteristics of postmenopausal women with CAD. Materiels and methods A total of 87 postmenopausal women (over 50 years) and 68 premenopausal women who underwent coronary angiography in Ibn Roche Center of Cardiology from June to December 2014 were enrolled. The clinical data and coronary angiographic characteristics (presence, localization, length and severity) were compared between the premenopausal and postmenopausal CAD groups. Results Postmenopausal CAD patients presented more frequently with hypertension, diabetes mellitus and dyslipidemia compared with premenopausal CAD patients (66.0% vs. 55.0%, 31.5% vs. 15.0%, 37.4% vs. 23.9%, respectively; all P P  = 0), and triple vessels in postmenopausal CAD patients (33.8% vs. 20.4%, P  = 0), much more severe lesions (> or = 90%) at left main (2.9% vs. 1.1%, P  = 0.048) and proximal left anterior descending artery (LAD) (28.2% vs. 16.6%, P  = 0) in the postmenopausal CAD group were found. Conclusion Postmenopausal patients frequently combine many risk factors, and comorbidities that impact the prognosis, also their angiographic status was characterized by the spread and complexity of the coronary disease. The estrogen deficiency could be a physiopathological explanation for these results.