Acute Coronary Syndromes in Women: Angiographic Features

Problematic and Objectives: The incidence of coronary artery disease appears to be higher in men than in women. Nevertheless cardiovascular mortality is higher in women than in men. The objective of this study is to find if there are particular angiographic features that can explain this overmortality in women.

Methods: This is a retrospective descriptive and analytical study of 191 women with acute coronary syndrome who went through coronarography over a period of 5 years. We collected the angiographic findings that we analysed using the statistical software SPSS version 18. Our results were then compared to the findings of the literature.

Results: In our study, the incidence of acute coronary syndrome (ACS) in women was 4.4 times lower than in men. Menopause was the first cardiovascular risk factor and was found in 93.2% of our patients, followed by hypertension with a prevalence of 60.7%. Fifth-six point five percent of our patients were diabetic. Dyslipidemia was found in 39.9% of our patients, smoking in 4.7%. All our patients underwent coronary angiography. The angiography was performed radially in 52% of the patients and femorally in 48% of the cases. It was normal with no significant lesions in 17% of cases. Atheromatous lesions dominated. Forty five percent of the patients had mono-vessel coronary lesion, 28% had bi-vessel coronary lesion, and 27% tri-vessel coronary lesion.

Conclusion: Women generally have less extensive and less obstructive coronary disease. However, mortality is higher in women. A more careful approach to diagnosis and more invasive management is needed to reduce female mortality.