INFLUENCE OF AGE AND COMORBIDITY ON TREATMENT STRATEGY IN WOMEN WITH ISCHEMIC HEART DISEASE

Abstract

Age-related physiological changes and the accumulation of comorbid conditions play a pivotal role in shaping the clinical presentation and management of ischemic heart disease (IHD) in women. The aim of this study was to evaluate the impact of age and comorbidity burden on disease characteristics and revascularization strategies. A total of 483 female patients with confirmed coronary artery disease were analyzed and stratified according to age and reproductive status. A significant age-dependent increase in major cardiovascular risk factors was identified, including arterial hypertension (up to 86.3%), dyslipidemia (up to 68.6%), carotid artery stenosis (exceeding 70%), and prior myocardial infarction (up to 61.4%) (p < 0.001). Severe heart failure (NYHA class III) was present in 77.8–98.0% of patients, with the highest prevalence observed in older age groups. Dyspnea was the predominant clinical manifestation, reflecting the central role of cardiac dysfunction in symptomatology. Treatment strategies differed significantly across age groups: minimally invasive approaches, particularly coronary stenting, were more frequently applied in elderly patients due to increased surgical risk, whereas coronary artery bypass grafting (CABG) was more commonly performed in middle-aged patients with complex coronary lesions. These findings highlight the critical importance of age-adapted, personalized clinical decision-making in women with IHD.