Traditional and Non-Traditional Risk Factors of Acute Coronary Syndrome in Young Women: Evidence from the ANCORS-YW Study

Purpose: Young women are at risk of acute coronary syndrome (ACS). They represent a unique population exposed to traditional cardiovascular risk factors and female sex-specific, non-traditional risk factors. The current study aimed to describe traditional and non-traditional risk factors of ACS in young women from the Middle East. Patients and Methods: The present study used data from the Jordanian, nationwide, multicenter, case-control study, ANCORS-YW. Bivariate analyses and logistic regression models were used to predict independent risk factors of ACS using adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results: The study included 572 young women (≤50-years) with a median age of 45-years, divided into an ACS group (n=154, 26.9%) and a control group with no atherosclerotic cardiovascular disease (n=418, 73.1%). The most common presentation of ACS was non-ST-elevation ACS (n=98, 64%). The ACS group, compared to control group, had higher proportions of type-2 diabetes (41.6%vs.11.7%, p<0.001), hypertension (53.9%vs.23.4%, p<0.001), tobacco use (37.7%vs.24.2%, p=0.001), family history of cardiovascular disease (53.2%vs.23.4%, p<0.001), metabolic syndrome (14.3%vs.2.4%, p<0.001), and preterm delivery (24.7%vs.16.7%, p=0.032). ACS group had nonsignificantly greater proportions of hypertensive disorders of pregnancy (29.2%vs.22.7%, p=0.109) and gestational diabetes (15.6%vs.10.3%, p=0.081). Multivariable logistic regression analyses identified five independent predictors of ACS: type-2 diabetes (AOR, 95% CI: 3.45, 1.98─5.99), family history of cardiovascular disease (3.33, 2.15─5.17), tobacco use (2.01, 1.26─3.21), hypertension (1.72, 1.07─2.78), and metabolic syndrome (4.35, 1.72─11.03). Conclusion: Modifiable risk factors play an important role in ACS risk among young women. Efforts should be made to improve primordial and primary prevention in this population.