Title:The Risk Factors of Acute Coronary Syndrome in Young Women:
A Systematic Review and Meta-Analysis
Volume: 19
Issue: 3
Author(s): Sisca Natalia Siagian, Christianto Christianto*, Phoniex Angellia and Ho Indra Holiyono
Affiliation:
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Keywords:
Acute coronary syndrome, atherosclerosis, meta-analysis, risk factors, ACS, young women.
Abstract:
Background: Acute coronary syndrome (ACS) has been one of the leading causes of
mortality in the world. Despite common understanding regarding ACS as an older population’s or
man's disease, the number of young women affected by this condition is increasing. Many studies
have assessed the risk factors of ACS, but only a few studies focused on this subpopulation. Therefore,
this systematic review and meta-analysis aim to evaluate the risk factors predisposing to ACS
in the young women population.
Methods: Nine online databases were screened from the date of inception to September 2021,
where the acquired studies were evaluated using the PRISMA statement. The inclusion criteria
were a case control study with women age cut-off of <50 years. The risk factors of acute coronary
syndrome were analyzed using a random-effect model, expressed as summary statistics of odds ratio
(OR) for categorical variable and standard mean difference (SMD) for continuous data with
normal distribution, with 95% confidence interval (CI). Quality assessment was conducted using
the STROBE statement.
Results: Seven studies with the total of 7042 patients met the inclusion criteria of this metaanalysis.
Diabetes mellitus, high BMI, obesity, hypercholestrolemia, hypertension, smoking, and
family history significantly increased acute coronary syndrome risk in young women. Other risks
such as heavy alcohol consumption, oral contraceptive use, and postmenopausal state were associated
with higher risk of ACS.
Conclusion: The independent risk factors which are strongly related to ACS in young women were
diabetes mellitus, hypertension, and hypercholesterolemia with odd ratios of 6.21, 5.32, and 4.07.
Other risk factors which may be associated with an increased risk of ACS in young women were
heavy alcohol consumption, oral contraceptive use, and postmenopausal state. Health promotion
and effective intervention on this specific population regarding these risk factors can decrease
young female cardiovascular morbidity and mortality as well as improved quality of life of women.