166 - EVALUATION OF FEMALE-SPECIFIC RISK FACTORS AND THEIR ASSOCIATION WITH MYOCARDIAL INFARCTION OCCURRENCE IN WOMEN FROM THE QUEBEC CARTAGENE ADMINISTRATIVE DATABASE.

Background: Nontraditional risk factors (NRF) specific to women’s life trajectory are understudied. These include gestational diabetes, age at menarche, early menopause, fertility treatment, contraceptive use, the use of hormone replacement therapy (HRT), and breast, uterine, and ovarian cancers. There is a clear need for improved understanding of the role of such NRF of women throughout their lifespan on the development of cardiovascular disease (CVD) and more specifically, myocardial infarction (MI). The aim of this study was to determine whether there is an association between NRF and MI in women from the Quebec CARTaGENE administrative database.

METHODS AND RESULTS: An epidemiological analysis was conducted using the CARTaGENE database, which collected data from a population-based cohort followed prospectively through questionnaires. 23,793 women were recruited during one of two phases (phase A from 2009 to 2010 and phase B from 2013 to 2014). These women were from Montreal, Quebec, Gatineau, Sherbrooke, Saguenay and Trois-Rivières, with ages ranging from 40 to 69 years. Associations between NRF in women with and without MI were determined by carrying out different statistical analyses including chi-square, risk ratio (RR), independent samples T-test, multivariate logistic regression, and descriptive analyses using SPSS software. Out of 23,793 women, 197 (0.9%) were found to have a history of MI. MI occurrence was associated with breast cancer (RR 2.0 [95%CI: 1.2-3.6]), uterine cancer (RR 5.9 [95%CI 2.8-12.3]) and menopause (RR: 3.9 [95%CI: 2.7-5.6]), while RRs for gestational diabetes (RR: 1.4 [95%CI: 0.6-3.4]) and HRT use (RR: 1.3 [95%CI: 0.9-1.7]) did not suggest a strong association. MI occurrence was associated with earlier menarche (average age at menarche: 12.3 (SD 2.1) vs. 12.8 (2.7), p=0.003) and earlier menopause (age at menopause: 44.9 (8.5) vs. 47.8 (6.7), p < 0.001). Finally, women with MI had an average of 2.3 NRF compared to 1.9 for those without MI (p-value < 0.001).


Conclusion: Multiple CVD female-specific NRF were found to be associated with MI in a cohort of Quebec women. More research is warranted to better understand the significance of these associations, potentially contributing to upstream prevention of CVD.