Abstract / Summary
Objective: Young women with acute myocardial infarction (AMI) often present with distinct risk profiles compared with older women and men, but the role of reproductive factors remains poorly understood. This study examines associations of reproductive factors with AMI in young women. Methods: We conducted a case-control study of 1561 women aged 18–55 years with AMI from VIRGO and age-matched controls from NHANES. A wide range of reproductive factors were evaluated. Conditional logistic regression estimated odds ratios for AMI, sequentially adjusted for race/ethnicity, socioeconomic variables, and traditional risk factors. Stratified analyses were performed by menopausal status. Results: Early menarche (<11 years; OR 2.07, 95% CI 1.56–2.73), menopause (OR 1.82, 95% CI 1.50–2.22), gestational diabetes (OR 1.65, 95% CI 1.23–2.19), birth control pills use for 1–5 years (OR 1.67, 95% CI 1.36–2.05), and ever use of female hormones (OR 1.99, 95% CI 1.62–2.46) were associated with higher odds of AMI, while first live birth at ≥30 years (OR 0.50, 95% CI 0.36–0.69), breastfeeding ≥1 month (OR 0.46, 95% CI 0.38–0.56), and current contraceptive use (OR 0.49, 95% CI 0.32–0.76) were associated with lower odds. After adjustment for traditional risk factors, birth control pills use for 1–5 years (OR 1.71, 95% CI 1.25–2.34) and female hormone use (OR 1.75, 95% CI 1.28–2.38) remained significantly associated. Associations varied by menopausal status. Conclusion: Reproductive factors are associated with early-onset AMI in young women. Recognition of reproductive history may inform prevention strategies in young women.