COMPARATIVE ANALYSIS OF RISK FACTORS AND SHORT-TERM OUTCOMES AFTER PRIMARY PCI IN PRE- AND POST-MENOPAUSAL WOMEN WITH STEMI EXPERIENCE FROM LMIC
Author(s)
Shumaila Furnaz, MSc;
National Institute of Cardiovascular Diseases, Manager Research, Karachi, Pakistan
National Institute of Cardiovascular Diseases, Manager Research, Karachi, Pakistan
OBJECTIVES: Comparing the prevalence of conventional and non-conventional risk factors of atherosclerotic cardiovascular disease between pre- and post-menopausal women in Pakistan
METHODS: This cohort study was conducted at the National Institute of Cardiovascular Disease (NICVD), Karachi, Pakistan, between May and October 2025. We have recruited two independent cohorts of women diagnosed with STEMI. The first cohort consisted of consequently selected pre-menopausal women, while, second cohort consisted of consequently selected post-menopausal women. The two cohorts were compared in terms of clinical and demographic characteristics and in-hospital outcomes using appropriate independent sample t-test or chi-squared test at 5% level of significance.
RESULTS: A total of 210 female STEMI patients were enrolled, including 58 (27.6%) premenopausal and 152 (72.4%) postmenopausal women. Mean age was 41 ± 7.3 and 55.8 ± 7.5 years, respectively. Both groups were similar in BMI, education, occupation, income, and family history (p > 0.05). Diabetes was more common post menopause (56.6% vs 34.5%; p = 0.004), while preeclampsia and gestational diabetes were higher pre menopause (p < 0.01). Premenopausal women reported more dyspnea (72.4% vs 50%; p = 0.003) and substance use, whereas sedentary lifestyle was greater post menopause (p = 0.006). Single-vessel disease predominated perimenopause (55.2% vs 32.9%), and three-vessel disease post menopause (38.2% vs 19%). RCA was the most affected vessel in both, with TIMI III flow achieved in >96% and no in-hospital mortality.
CONCLUSIONS: Premenopausal women with STEMI showed higher pregnancy-related cardiovascular risks, while metabolic factors, particularly diabetes, predominated post menopause. Preventive screening for pregnancy-related conditions should be included in women’s health programs, alongside lifestyle interventions promoting tobacco cessation and physical activity in younger women. Postmenopausal women require strict metabolic risk management. Further research is needed to explore hormonal and non-traditional determinants of early-onset CAD in South Asian women.
METHODS: This cohort study was conducted at the National Institute of Cardiovascular Disease (NICVD), Karachi, Pakistan, between May and October 2025. We have recruited two independent cohorts of women diagnosed with STEMI. The first cohort consisted of consequently selected pre-menopausal women, while, second cohort consisted of consequently selected post-menopausal women. The two cohorts were compared in terms of clinical and demographic characteristics and in-hospital outcomes using appropriate independent sample t-test or chi-squared test at 5% level of significance.
RESULTS: A total of 210 female STEMI patients were enrolled, including 58 (27.6%) premenopausal and 152 (72.4%) postmenopausal women. Mean age was 41 ± 7.3 and 55.8 ± 7.5 years, respectively. Both groups were similar in BMI, education, occupation, income, and family history (p > 0.05). Diabetes was more common post menopause (56.6% vs 34.5%; p = 0.004), while preeclampsia and gestational diabetes were higher pre menopause (p < 0.01). Premenopausal women reported more dyspnea (72.4% vs 50%; p = 0.003) and substance use, whereas sedentary lifestyle was greater post menopause (p = 0.006). Single-vessel disease predominated perimenopause (55.2% vs 32.9%), and three-vessel disease post menopause (38.2% vs 19%). RCA was the most affected vessel in both, with TIMI III flow achieved in >96% and no in-hospital mortality.
CONCLUSIONS: Premenopausal women with STEMI showed higher pregnancy-related cardiovascular risks, while metabolic factors, particularly diabetes, predominated post menopause. Preventive screening for pregnancy-related conditions should be included in women’s health programs, alongside lifestyle interventions promoting tobacco cessation and physical activity in younger women. Postmenopausal women require strict metabolic risk management. Further research is needed to explore hormonal and non-traditional determinants of early-onset CAD in South Asian women.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR167
Topic
Patient-Centered Research
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)