Characteristics and short-term outcomes of young women with acute myocardial infarction in Malaysia: a retrospective analysis from the Malaysian National Cardiovascular Database registry

Objective Young women form a minority but an important group of patients with acute myocardial infarction (MI) as it can potentially cause devastating physical and socioeconomic impact. This study was aimed to investigate the characteristics and outcomes of young women with MI in Malaysia.Design Thi...

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Main Authors: Padmaa Venkatason, Yong Z Zubairi, Wan Azman Wan Ahmad, Muhammad Imran Hafidz, Muhammad Dzafir Ismail, Mohd Firdaus Hadi, Ahmad Syadi Mahmood Zuhdi, Nur Lisa Zaharan, Norashikin Md Sari
Format: Article
Language:English
Published: BMJ Publishing Group 2019-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/11/e030159.full
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author Padmaa Venkatason
Yong Z Zubairi
Wan Azman Wan Ahmad
Muhammad Imran Hafidz
Muhammad Dzafir Ismail
Mohd Firdaus Hadi
Ahmad Syadi Mahmood Zuhdi
Nur Lisa Zaharan
Norashikin Md Sari
author_facet Padmaa Venkatason
Yong Z Zubairi
Wan Azman Wan Ahmad
Muhammad Imran Hafidz
Muhammad Dzafir Ismail
Mohd Firdaus Hadi
Ahmad Syadi Mahmood Zuhdi
Nur Lisa Zaharan
Norashikin Md Sari
author_sort Padmaa Venkatason
collection DOAJ
description Objective Young women form a minority but an important group of patients with acute myocardial infarction (MI) as it can potentially cause devastating physical and socioeconomic impact. This study was aimed to investigate the characteristics and outcomes of young women with MI in Malaysia.Design This is a retrospective analysis of women with ST-elevation MI (STEMI) and non-STEMI (NSTEMI) from 18 hospitals across Malaysia using the Malaysian National Cardiovascular Database registry–acute coronary syndrome (NCVD-ACS).Participants Women patients diagnosed with acute MI from year 2006 to 2013 were identified and divided into young (age ≤45, n=292) and older women (age >45, n=5580).Primary outcome measure Comparison of demographics, clinical characteristics and in-hospital management was performed between young and older women. In-hospital and 30-day all-cause mortality were examined.Results Young women (mean age 39±4.68) made up 5% of women with MI and were predominantly of Malay ethnicities (53.8%). They have a higher tendency to present as STEMI compared with older women. Young women have significantly higher rates of family history of premature coronary artery disease (CAD) (20.5% vs 7.8% p<0.0001). The prevalence of risk factors, such as hypertension, diabetes and dyslipidaemia was high in both groups. The primary reperfusion strategy was thrombolysis with no significant differences observed in the choice of intervention for both groups. Other than aspirin, rates of prescriptions for evidence-based medications were similar with >80% prescribed statins and aspirin. The all-cause mortality rates of young women were lower for both in-hospital and 30 days, especially in those with STEMI with adjusted mortality ratio to the older group, was 1:9.84.Conclusion Young women with MI were over-represented by Malays and those with a family history of premature CAD. Preventive measures are needed to reduce cardiovascular risks in young women. Although in-hospital management was similar, short-term mortality outcomes favoured young compared with older women.
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spelling doaj-art-7ecfee7eaf4b42d3a7c0da3f6d8b113e2025-08-20T02:05:32ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-030159Characteristics and short-term outcomes of young women with acute myocardial infarction in Malaysia: a retrospective analysis from the Malaysian National Cardiovascular Database registryPadmaa Venkatason0Yong Z Zubairi1Wan Azman Wan Ahmad2Muhammad Imran Hafidz3Muhammad Dzafir Ismail4Mohd Firdaus Hadi5Ahmad Syadi Mahmood Zuhdi6Nur Lisa Zaharan7Norashikin Md Sari81 Department of Medicine, University of Malaya Faculty of Medicine, Kuala Lumpur, Malaysia2 Foundation Studies in Science, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia4 Cardiology Unit, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia4 Cardiology Unit, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia4 Cardiology Unit, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia4 Cardiology Unit, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia4 Cardiology Unit, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia3 Department of Pharmacology, University of Malaya Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia4 Cardiology Unit, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, MalaysiaObjective Young women form a minority but an important group of patients with acute myocardial infarction (MI) as it can potentially cause devastating physical and socioeconomic impact. This study was aimed to investigate the characteristics and outcomes of young women with MI in Malaysia.Design This is a retrospective analysis of women with ST-elevation MI (STEMI) and non-STEMI (NSTEMI) from 18 hospitals across Malaysia using the Malaysian National Cardiovascular Database registry–acute coronary syndrome (NCVD-ACS).Participants Women patients diagnosed with acute MI from year 2006 to 2013 were identified and divided into young (age ≤45, n=292) and older women (age >45, n=5580).Primary outcome measure Comparison of demographics, clinical characteristics and in-hospital management was performed between young and older women. In-hospital and 30-day all-cause mortality were examined.Results Young women (mean age 39±4.68) made up 5% of women with MI and were predominantly of Malay ethnicities (53.8%). They have a higher tendency to present as STEMI compared with older women. Young women have significantly higher rates of family history of premature coronary artery disease (CAD) (20.5% vs 7.8% p<0.0001). The prevalence of risk factors, such as hypertension, diabetes and dyslipidaemia was high in both groups. The primary reperfusion strategy was thrombolysis with no significant differences observed in the choice of intervention for both groups. Other than aspirin, rates of prescriptions for evidence-based medications were similar with >80% prescribed statins and aspirin. The all-cause mortality rates of young women were lower for both in-hospital and 30 days, especially in those with STEMI with adjusted mortality ratio to the older group, was 1:9.84.Conclusion Young women with MI were over-represented by Malays and those with a family history of premature CAD. Preventive measures are needed to reduce cardiovascular risks in young women. Although in-hospital management was similar, short-term mortality outcomes favoured young compared with older women.https://bmjopen.bmj.com/content/9/11/e030159.full
spellingShingle Padmaa Venkatason
Yong Z Zubairi
Wan Azman Wan Ahmad
Muhammad Imran Hafidz
Muhammad Dzafir Ismail
Mohd Firdaus Hadi
Ahmad Syadi Mahmood Zuhdi
Nur Lisa Zaharan
Norashikin Md Sari
Characteristics and short-term outcomes of young women with acute myocardial infarction in Malaysia: a retrospective analysis from the Malaysian National Cardiovascular Database registry
BMJ Open
title Characteristics and short-term outcomes of young women with acute myocardial infarction in Malaysia: a retrospective analysis from the Malaysian National Cardiovascular Database registry
title_full Characteristics and short-term outcomes of young women with acute myocardial infarction in Malaysia: a retrospective analysis from the Malaysian National Cardiovascular Database registry
title_fullStr Characteristics and short-term outcomes of young women with acute myocardial infarction in Malaysia: a retrospective analysis from the Malaysian National Cardiovascular Database registry
title_full_unstemmed Characteristics and short-term outcomes of young women with acute myocardial infarction in Malaysia: a retrospective analysis from the Malaysian National Cardiovascular Database registry
title_short Characteristics and short-term outcomes of young women with acute myocardial infarction in Malaysia: a retrospective analysis from the Malaysian National Cardiovascular Database registry
title_sort characteristics and short term outcomes of young women with acute myocardial infarction in malaysia a retrospective analysis from the malaysian national cardiovascular database registry
url https://bmjopen.bmj.com/content/9/11/e030159.full
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