0151: Evaluation of the screening for myocardial ischemia among women at cardiovascular risk

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• 作者：Anne-Laure Madika ; ^{annamad8@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Fanny Boudghene ; Pascal Delsart ; Claire Mounier-Vehier
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：8
• 期：1
• 页码：6
• 全文大小：52 K

文摘

Coronary artery disease is the leading cause of cardiovascular diseases, which remains the major cause of death for women. Prevention, screening and diagnosis tend to be performed at late stages and less frequently, and treatments are not optimal in women. The consequences of a targeted screening for myocardial ischemia in women at risk have not yet been studied.

Methods

We conducted a prospective observational study with retrospective data collection based on a cohort of female patients at cardiovascular risk, with or without symptoms, who benefited from a non-invasive diagnostic test, offered through the care pathway “Heart, arteries and women” from the Lille University hospital of Lille, between January 1st, 2013 and June 31st, 2014. The objective was to determine the relevance of this screening and which factors would help in targeting women more efficiently.

Results

The screening gave a positive result in for 15.7% of the 287 women included.

Among the 30 women that benefited from a coronarography, 72% had no obstructive coronary artery disease. The independent predictive factors of a positive screening were a menopause since more than 5 years (OR=4.17; p=0.001), an HDL-c ≤0.5 g/dL (OR=2.45; p=0.023) and an IMC ≥32 (OR=4.58; p=0.0001). A clinical coronary score based on these factors was developed to target the screening (AUC 0.765). The symptoms, presents in half of the patients, were predictive of a positive screening (p=0.010) but were mostly atypical.

The classical cardiovascular risk scores were inefficient at predicting a coronary artery disease (AUC 0.618 to 0.681). The positive screening had resulted into a low rate of revascularization (17%) but in a significant increase of in the prescription of statin (p=0.002), antiplatelet agents (p<0.0001) and beta blockers (p=0.024).

Conclusion

The screening for myocardial ischemia among selected women at risk of cardiovascular diseases allows optimizing their care in secondary prevention.