Age at Menopause and Extent of Coronary Artery Disease Among Postmenopausal Women with Acute Coronary Syndromes

Age at menopause, extent of coronary artery disease and outcome among postmenopausal women with acute coronary syndromes

“…However, clinical studies investigating the outcomes of postmenopausal women with acute coronary syndrome (ACS) in relation to their age at menopause onset are lacking. In the report of the Ladies ACS study, we showed that age at menopause was not related to the extent of coronary artery disease among postmenopausal women with an ACS [12]. In the present paper, we report the one-year follow-up of that cross-sectional study, to address the issue of whether menopausal age is associated with clinical outcome after an ACS.…”

“…The LADIES ACS study was aimed at investigating whether age at menopause is associated with the extent of angiographically quantified coronary atherosclerosis in the post-menopausal decades [12]. The answer was clearly that it is not: the extent of coronary disease increased with aging, but didn't show any correlation with menopausal age, both in terms of the overall burden of coronary lesions (Gensini score), and in terms of critical lesions (SYNTAX score).…”

“…We studied the coronary angiograms of postmenopausal women with acute MI, of which 85% were at their first episode [12], and correlated this data with menopausal age, and prospectively with one-year outcome. We found no material differences in baseline characteristics, except for the presence of chronic kidney dysfunction, a powerful prognostic indicator and marker of macro-and microvascular damage [22], which was more frequent among women with early menopause.…”

“…The Ladies ACS study (NCT01997307) is a prospective, multicenter investigation including postmenopausal women and age-matched men with an ACS, stratified in 4 tenyear age groups (55-64, 65-74, 75-85 and N85 years) with a sampling ratio of 2:1 of women vs men. The details of the study design have been described previously [12]. The focus of the study was angiographic, with a corelab analysis of the angiograms collected at the study sites.…”

Menopause and Cardiovascular Implication

“…This study revealed that extent of the coronary disease shows a correlation with absolute age after 55 years but no correlation with the age of menopause. [14] Dyslipidemia Low plasma estrogen levels may explain unfavorable lipid and carbohydrate metabolism changes rapidly occurring during menopausal transition and soon after menopause. No difference was observed in HDL, LDL, HDL:TC ratio, fasting insulin, and the ratio of fasting insulin to fasting blood glucose between women with premature ovarian failure with a mean age of 32.8 years and in those during natural menopausal transition with a mean age of 52.…”