scholarly journals Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Priyadarshani Galappatthy ◽  
Vipula Bataduwaarachchi ◽  
Priyanga Ranasinghe ◽  
Gamini Galappatthy ◽  
Upul Senerath ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Sri Lanka ◽  
Disease Risk ◽  
Management Strategies ◽  
Significant Proportion ◽  
Coronary Syndrome ◽  
One Year ◽  
Grace Score

Objective. To assess sex-based differences in the prevalence of risk factor, their management, and differences in the prognosis among acute coronary syndrome (ACS) in Sri Lanka. Methods. Patients diagnosed with ACS were recruited from hospitals throughout the island. The Joint European Societies guidelines were used to assess recommended targets for coronary heart disease risk factors, and the GRACE score was used to assess the post-ACS prognosis. Age-adjusted regression was performed to calculate odds ratios for men versus women in risk factor control. Results. A total of 2116 patients, of whom 1242 (58.7%) were men, were included. Significant proportion of women were nonsmokers; OR = 0.11 (95% CI 0.09 to 0.13). The prevalence of hypertension (p<0.001), diabetes (p<0.001), and dyslipidemia (p=0.004) was higher in women. The LDL-C target was achieved in a significantly higher percentage of women (12.6%); OR = 0.33 (95% CI 0.10 to 1.05). When stratified by age, no significant differences were observed in achieving the risk factor targets or management strategies used except for fasting blood sugar (p<0.05) where more men achieved control target in both age categories. Majority of the ACS patients had either high or intermediate risk for one-year mortality as per the GRACE score. In-hospital and 1-year mean mortality risk was significantly higher among men of less than 65 years of age (p<0.05). Conclusions. Smoking is significantly lower among Sri Lankan women diagnosed with ACS. However, hypertension, diabetes, and dyslipidemia were more prevalent among them. There was no difference in primary and secondary preventive strategies and management in both sexes but could be further improved in both groups.

scholarly journals Acute Coronary Syndrome in the Young - Risk Factors and Angiographic Pattern

1970 ◽  
Vol 2 (2) ◽  
pp. 175-178 ◽  
Author(s):  
AFMS Haque ◽  
AR Siddiqui ◽  
SMM Rahman ◽  
SA Iqbal ◽  
NN Fatema ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Older Patients ◽  
Young Patients ◽  
Military Hospital ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Common Risk Factor ◽  
Coronary Syndrome

Background: Coronary artery disease (CAD) is a worldwide health epidemic. Acute coronary syndrome is a potentially life-threatening condition and patient may die or become disabled in the prime of life. There is documented evidence that South Asian people develop CAD at a higher rate and also at an early age. If the affected individual is 40 yrs old or below, the tragic consequences are catastrophic. Methods: It was a retrospective observational study to find out the pattern of acute coronary syndrome in the young (40 years old or less) in a military hospital (CMH Dhaka) from July 2007 to July 2008 and to analyze the risk factors and the angiographic characteristics of coronary vessels. Consecutive 64 young patients including both male and female admitted into this hospital were the study subjects. Out of these patients 53 were males and 11 were females. Among these patients coronary risk factors and angiographic pattern were studied. 64 older patients with Acute coronary syndrome (age more than 40 years) were also studied. Results: Out of 64 young patients 15.6% patients presented to this hospital as UA, 9.37% presented as Non-Q MI, 28.12% Acute Anterior MI, 14.06% Acute Anteroseptal MI, 26.56% Acute Inferior MI, 6.25% Acute Infero-posterior MI. Smoking was the most common risk factor among these young patients. 64.06% patients were smoker. Dyslipidaemia was present among 50% patients, 37.55% were hypertensive, 15.62% were diabetic, and 15.62% were obese. SVCAD was the most common lesion and it was 53.12%. 26.56% patients had DVCAD and TVCAD was present among 20.31% patients. In the older group (more than 40 years) most common risk factor was dyslipidaemia (71.88%) and smoking was present among 48.43% patients. Conclusion: Young patients have a different risk factor profile in comparison with older patients. Smoking is a strong and quite common coronary risk factor in the young ACS patients who are 40 years or less. Risk factor identification and control is very crucial in the primary and secondary prevention in young patients with CAD. Keywords: Acute coronary syndrome; Risk factors; Coronary Angiography DOI: 10.3329/cardio.v2i2.6635Cardiovasc. j. 2010; 2(2) : 175-178

scholarly journals Risk for recurrent cardiovascular events and expected risk reduction with optimal treatment one year after an acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Zafeiropoulos ◽  
I.T Farmakis ◽  
A Kartas ◽  
A Arvanitaki ◽  
A Pagiantza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Risk Reduction ◽  
Risk Score ◽  
Residual Risk ◽  
Stable Phase ◽  
Modifiable Risk Factors ◽  
Clinical Issue ◽  
Coronary Syndrome ◽  
One Year

Abstract Background According to the latest ESC Guidelines for chronic coronary syndromes (CCS), patients who suffered an acute coronary syndrome (ACS) pass to a chronic stable phase after one year. In these patients the estimated 10-year risk for recurrent cardiovascular (CV) events varies considerably. We estimated this risk and the expected risk reduction after optimal control. Methods We applied the SMART risk score in 211 patients one year after an ACS to estimate the 10-year risk for recurrent CV events (subsequent non-fatal myocardial infarction, non-fatal stroke, or cardiovascular death). We assessed the distribution of the estimated risk and the potential risk reduction that might be achieved with an optimal guideline-directed management of modifiable risk factors (systolic blood pressure, low-density lipoprotein cholesterol, smoking and body mass index). Results In our cohort, the median SMART score was 16% [interquartile range (IQR), 9.5–26]. If all modifiable risk factors met guideline-recommended targets, median SMART risk score would be 9.4% (IQR, 5.9–17.1), with 52% of the patients at a 10-year risk &lt;10%, while 10% and 11% at 20–30% and &gt;30% risk respectively. The total median reducible risk was 4.7% (IQR, 1.7–8.8). Conclusions The SMART score had a wide distribution among patients with CCS. Noteworthy, one out of five patients will remain at a &gt;20% 10-year risk, even with optimal risk factors management, clearly underlining that residual risk is an unmet clinical issue, which demands individualized patient care. Baseline and total residual risk score Funding Acknowledgement Type of funding source: None

scholarly journals Analysis of Cardiovascular Disease Risk Factors in Women

2018 ◽  
Vol 6 (8) ◽  
pp. 1370-1375 ◽  
Author(s):  
Maria Stanislavovna Tairova ◽  
Lucas Odacir Graciolli ◽  
Olga Sergueevna Tairova ◽  
Thiago De Marchi
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Acute Coronary Syndrome ◽  
Sports Medicine ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Complete Information ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Principal Factors

AIM: Study the cardiovascular risk factors in a feminine population vulnerable to cardiovascular events particularly to evaluate the principal factors or possible confounding variables.METHODS: This is a cross-sectional descriptive study. Were analysed all the female patients from the Cardiovascular Rehabilitation Institute of Sports Medicine of Caxias do Sul who had the complete information on cardiovascular disease history, comorbidities and habits and who knew the complete gynaecological history by a phone interview.RESULTS: Were analysed 91 patients. About the comorbidities and habits, 45.2% of these patients presented some tobacco load, 82.4% are hypertensive, 61.5% are dyslipidemic, 25.3% are diabetic and the BMI average was 29.27 (overweight). Between the patients who undergone a hysterectomy and had an episode of the acute coronary syndrome (10 patients), 70% had the event after the procedure. Between the post-menopause women with at least one episode of the acute coronary syndrome, 80.5% (33 patients) had the first event after the menopause.CONCLUSION: We found multiple lifetime risk factors that predisposed the women of the sample to have cardiovascular disease. Between the women with specific to women risk factors and without, the prevalence of cardiovascular disease was very similar. This information supports the idea that these are just confounding factors of CVD and the principals involved are the genetic factors and habits. For this reason, the focus of CVD prevention and treatment should be directed towards these aspects.

scholarly journals Epidemiology and risk factors of patients with types of acute coronary syndrome presenting to a tertiary care hospital in Sri Lanka

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Udaya Ralapanawa ◽  
Pallegoda Vithanage Ranjith Kumarasiri ◽  
Kushalee Poornima Jayawickreme ◽  
Prabashini Kumarihamy ◽  
Yapa Wijeratne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Sri Lanka ◽  
Unstable Angina ◽  
Stable Angina ◽  
Strong Association ◽  
Coronary Syndrome ◽  
History Of ◽  
St Elevation

Abstract Background Acute Coronary Syndrome (ACS) is one of the leading causes of death worldwide and studies have shown higher mortality rates and premature death in South Asian countries. The occurrence and effect of risk factors differ by type ofACS.Epidemiological studies in the Sri Lankan population are limited. Methods This is a cross sectional descriptive study conducted at the Teaching Hospital Peradeniya, Sri Lanka among patients presenting with ACS. Data was collected by an interviewer administered structured questionnaire and epidemiological patterns and risk factors were analyzed. Results The sample of 300 patients had a mean age of 61.3+/− 12.6 and male sex showed higher association with all three type of ACS compared to female with a P value of 0.001. This study showed higher mean age of 62.2 ± 11.4 years amongst unstable angina (UA) patients and 61.9 ± 14.5 years amongst non ST elevation myocardial infarction (NSTEMI) patients compared to 59.2 ± 11.2 years for ST elevation myocardial infarction (STEMI) patients with no significant statistical difference (P = 0.246). Approximately 55.8% STEMI patients, 39.8% UA and 35.5% NSTEMI patients were smokers indicating a significant association between smoking and STEMI (P = 0.017). Nearly 54.5% STEMI, 35.4% UA and 32.7% NSTEMI patients consumed alcohol and there was a very strong association between alcohol consumption and STEMI (P = 0.006). Almost 51.8% NSTEMI patients, 47.8% UA patients and 29.9% STEMI patients had hypertension(HT) (P = 0.008) indicating significant association of HT with UA and NSTEMI. About 33.6% UA patients and 30.0% NSTEMI patients had DM whilst only 22.1% of STEMI patients had DM of no significance (p = 0.225). Around 15.0% patients with UA, 25.5% with NSTEMI and 11.7% with STEMI had dyslipidemia (P = 0.032). There was a very strong association between a past history of ACS or stable angina with NSTEMI and UA (P = 0.001). Conclusion Smoking and alcohol abuse are significantly associated with STEMI.Patients with NSTEMI or Unstable Angina had higher rates of hypertension and were more likely to have a history of ACS or stable angina than STEMI patients. Patients with NSTEMI were more likely than patients with STEMI or UA to have dyslipidemia.

scholarly journals Acute Coronary Syndrome in Malaysian Octogenarian: Trends in Demographics and In-Hospital Managements

2021 ◽  
Author(s):  
Siti Zaleha Suki ◽  
Ahmad Syadi Mahmood Zuhdi ◽  
Abqariyah Yahya ◽  
Nur Lisa Zaharan
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Disease Risk ◽  
Angiotensin Receptor Blockers ◽  
Coronary Intervention ◽  
Evidence Based ◽  
Age Group ◽  
Converting Enzyme Inhibitors ◽  
Coronary Syndrome ◽  
To Receive

Abstract Background: Octogenarians have often been neglected in the populational study of disease despite being at the highest point of non-modifiable disease risk burden and the fastest-growing age group for the past decade. This study examined the characteristics and in-hospital management of octogenarian patients with acute coronary syndrome (ACS).Method: This retrospective study utilised the Malaysian National Cardiovascular Disease- ACS (NCVD-ACS) registry. Patients ≥ 80 years old admitted with ACS at 23 participating hospitals from 2008 to 2017 (n=3,080) were identified. Demographics, in-hospital intervention, and evidence-based pharmacotherapies were examined. Binary logistic regression was used.Results: Octogenarians made up 3.8% of patients with ACS in the NCVD-ACS registry (53% men, mean age=83.3, SD±3.4) within the 10-year. The largest ethnic group was Chinese (44%). Hypertension (78%) was the main CV risk factor. Most octogenarians (90.4%) have multiple CV risk factors. Non-ST-elevation myocardial infarction (NSTEMI) predominated (38%, p<0.001). Only 10% of octogenarians with ACS underwent percutaneous coronary intervention (PCI), the majority being STEMI patients (17.5%; p<0.05). More than 80% were prescribed aspirin (91.3%) either alone or combined, dual antiplatelet therapy (DAPT) (83.3%), anticoagulants (89.7%) and statins (89.6%), while less than half were prescribed angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (47.6%) and beta-blocker (43.0%). From 2008 until 2017, there were positive increments in cardiovascular intervention and pharmacotherapies. Men were more likely to receive PCI than women (Odds Ratio (OR): 0.698; 95%CI: 0.490-0.993). Those with NSTEMI (OR=0.402, 95% CI: 0.278-0.583) and unstable angina (UA) (OR=0.229, 95% CI: 0.143-0.366 were less likely to receive PCI but more likely to be given anticoagulants (NSTEMI, OR=1.543, 95% CI: 1.111-2.142; UA, OR=1.610, 95% CI: 1.120-2.314) than STEMI octogenarians. The presence of cardiovascular risk factors and comorbidities influences management. For example, those with congestive heart failure were more likely to be given PCI and evidence-based pharmacotherapies.Conclusion: Despite being the most vulnerable age group, octogenarians were conservatively treated with evidence-based treatment of ACS. As it is expected that the number of octogenarians with ACS will continue to increase thus the country needs to prepare to improve the management of this specific group of patients.

scholarly journals Risk Stratification and in Hospital Morality in Patients Presenting with Acute Coronary Syndrome (ACS) in Bahrain

2018 ◽  
Vol 12 (1) ◽  
pp. 7-17 ◽  
Author(s):  
Taysir S Garadah ◽  
Khalid Bin Thani ◽  
Leena Sulibech ◽  
Ahmed A Jaradat ◽  
Mohamed E Al Alawi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Systolic Hypertension ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Positive Serum ◽  
Grace Score

Background: Risk factors and short-term mortality in patients presented with Acute Coronary Syndrome (ACS) in Bahrain has not been evaluated before. Aim: In this prospective observational study, we aim to determine the clinical risk profiles of patients with ACS in Bahrain and describe the incidence, pattern of presentation and predictors of in-hospital clinical outcomes after admission. Methods: Patients with ACS were prospectively enrolled over a 12 month period. The rate of incidence of risk factors in patients was compared with 635 non-cardiac patient admissions that matched for age and gender. Multiple logistic regression analysis was used to predict poor outcomes in patients with ACS. The variables were ages >65 years, body mass index (BMI) >28 kg/m2, GRACE (Global Registry of Acute Coronary Events) score >170, history of diabetes mellitus (DM), systolic hypertension >180 mmHg, level of creatinine >160 μmol/l and Heart Rate (HR) on admission >90 bpm, serum troponin rise and ST segment elevation on the ECG. Results: Patients with ACS (n=635) were enrolled consecutively. Mean age was 61.3 ± 13.2 years, with 417 (65.6%) male. Mean age for patients with ST-segment elevation myocardial infarction (STEMI, n=156) compared with non-STEMI (NSTEMI, n=158) and unstable angina (UA, n=321) was 56.5± 12.8 vs 62.5±14.0 years respectively. In-hospital mortality was 5.1%, 3.1% and 2.5% for patients with STEMI, NSTEMI, and UA, respectively. In STEMI patients, thrombolytic therapy was performed in 88 (56.5%) patients and 68 (43.5%) had primary coronary angioplasty (PCI). The predictive value of different clinical variables for in-hospital mortality and cardiac events in the study were: 2.8 for GRACE score >170, 3.1 for DM, 2.2 for SBP >180 mmHg, 1.4 for age >65 years, 1.8 for BMI >28, 1.7 for creatinine >160 μmol/L, 2.1 for HR >90 bpm, 2.2 for positive serum troponin and 2.3 for ST elevation. Conclusion: Patients with STEMI compared with NSTEMI and UA were of younger age. There was higher in-hospital mortality in STEMI compared with NSTEMI and UA patients. The most significant predictors of death or cardiac events on admission in ACS were DM, GRACE Score >170, systolic hypertension >180 mmHg, positive serum troponin and HR >90 bpm.

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