CORONARY-ARTERY DISEASE IN YOUNG-WOMEN - RISK FACTOR-ANALYSIS AND LONG-TERM FOLLOW-UP

BACKGROUND Heart disease is the leading cause of death in women of all ages in the United States, but data on coronary disease in young wome n remains sparse. OBJECTIVE To identify and follow up a cohort of youn g women referred for the evaluation of coronary disease. METHODS Retro spective review of the medical records. RESULTS Thirty-two women young er than 31 years met the entry criteria. The average age was 28 +/- 2. 4 years, 28% had insulin-dependent diabetes mellitus, 38% had hyperten sion, 6% had congenital heart disease, 38% had a family history of cor onary artery disease, 72% were smokers, and 28% used oral contraceptiv es. Serum cholesterol levels were > 5.17 mmol/L (200 mg/dL) in 71%, an d the mean cholesterol level was 6.70 +/- 2 mmol/L (259 +/- 78 mg/dL). Resting electrocardiographic results were abnormal in 28 women (88%), 22 of whom had evidence of transmural myocardial infarction. Follow-u p averaged 9.8 +/- 6.4 years. Five patients died, all of whom had hype rtension, and 4 of whom had diabetic nephropathy and required dialysis . CONCLUSIONS Risk factors for coronary disease in young women include hypertension, hypercholesterolemia, diabetes mellitus, familial coron ary disease, and smoking. Long-term prognosis is excellent for those w ithout advanced diabetes mellitus and renal failure.