Abstract: Objective To investigate the risk factors and angiographic features of acute coronary syndrome (ACS) in women
below 50 years of age. Methods A total of 131 women with ACS aged 50 years or younger were enrolled in this study as the
case group, with another 425 women aged below 50 years with normal coronary angiographic findings as the control group.
The risk factors and clinical and coronary angiographic features of ACS were analyzed. Results Compared with the control
group, significantly higher frequencies of dyslipidemia, hypertension (especially diastolic hypertension), diabetes, or a positive
family history for coronary artery disease (CAD) were found in ACS group (P<0.05) . The proportion of post-menopausal
women and the menopausal ages were similar between the two groups (P>0.05), but the mean diastolic pressure was
significantly higher in ACS group than in the control group (P<0.05). Among the menopausal women, the conventional risk
factors for ACS were similar between the two groups with the exception of family history CAD, which was more frequent in
ACS group. Serum total cholesterol and triglyceride levels were significantly higher in ACS group than in the control group (P<
0.05), but the levels of high- and low-density lipoprotein cholesterol levels were comparable between them. Positive findings of
urine protein were more frequent in ACS group. In ACS group, 54.2% of the patients had a single diseased artery, 29.6% had
more than one diseased artery, and 16.0% had slightly diseased or even normal coronary arteries; the lesion was found most
commonly in the left anterior descending artery. Conclusion In women with ACS below 50 years of age, the risk factors of ACS
included the conventional risk factors of CAD and a positive finding of urine protein. Menopause is not associated with an
increased incidence of ACS. A substantial portion of these ACS patients can have slightly diseased and even normal coronary
arteries.