Introduction: Coronary artery disease (CAD) is one of the leading cause of morbidity and mortality in females, much more than breast cancer. Hormonal protection of premenopausal group is lost in postmenopausal age group and becomes similar to male counterparts. Traditional cardiac risk factors in women are similar to that in men but have different relative importance. Role of estrogen/progesterone, risks associated with oral contraceptives and controversial place of hormone replacement (HRT), requires special discussion. Women with CAD are more likely than men to present with angina rather than acute myocardial infarction (MI). Unstable angina is relatively common presentation. Atypical chest pain, microvascular angina are also more common in females. High rates of false positive treadmill test (TMT)/nuclear scans, atypical presentations, gender bias, psychosocial factors further compound the problem.
Materials and methods: Our study was conducted on 135 postmenopausal females over 2 years (2013–2015) attending cardiology outpatient department (OPD)/coronary care unit (CCU)/ward, L.P.S Institute of Cardiology, Kanpur, Uttar Pradesh, India.
Results and conclusion: Average age of patient was 64 ± 1.5 years. Chest pain was commonest presentation in 61.4% followed by dispend and palpitations. A total of 54.1% patients were in New York Heart Association (NYHA) class IV. Hypertension was most common risk factor, i.e., in 56.3% followed by dyslipidemia (45.9%), tobacco use (40.7%), obesity (31.9%) and diabetes in 23% cases. The most common electrocardiogram (ECG) finding on admission was T wave inversion (40%) followed by stress testing (ST) depression and normal ECG. Mean left ventricular fraction was 55.3 ± 11.3%. Unstable angina (38.5%) was the most common presentation followed by chronic stable angina (22.2%), ST elevated MI (20%) and non-ST elevated MI in 19.3% cases. 14.8% patients developed congestive heart failure (CHF) and died in hospital course.
Keywords: Postmenopausal period.
How to cite this article: Abdali N, Asif M. A Study of Coronary Artery Disease in Postmenopausal Women at Tertiary Center in North India. J South Asian Feder Menopause Soc 2016;4(2):81-87.
Source of support: Nil
Conflict of interest: None
Date of submission: 09 March 2016
Date of acceptance: 18 May 2016
Date of publication: July 2016