scholarly journals Gender differences in patients presenting with non-ST segment elevation myocardial infarction in the STAR registry

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Abdulhalim Jamal Kinsara ◽  
Yasser M. Ismail
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Epigastric Pain ◽  
Systolic Function ◽  
Female Group ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
The Mean

Abstract Background In most acute coronary artery (ACS) related literature, the female gender constitutes a smaller proportion. This study is based on gender-specific data in the Saudi Acute Myocardial Infarction Registry Program (STARS-1 Program). A prospective multicenter study, conducted with patients diagnosed with ACS in 50 participating hospitals. Results In total, 762 (34.12%) patients were diagnosed with non-ST segment elevation myocardial infarction. Of this group, only 164 (21.52%) were women. The mean age (64.52 ± 12.56 years) was older and the mean body mass index (BMI) was higher (30.58 ± 6.23). A significantly proportion was diabetic or hypertensive; however, a smaller proportion was smoking. Hyperlipidemia was present in 48%. The history of angina/MI/stroke and revascularization was similar, except for renal impairment. The presentation was atypical as only 70% presented with chest pain, and the rest with shortness of breath or epigastric pain. At presentation, the female group were more tachycardiac, had higher blood pressure, and a higher incidence of being in class 11-111 Killip heart failure. Only 32% had a normal systolic function, and the majority had either mild or moderate systolic dysfunction. In particular, the rate of percutaneous coronary intervention was similar. The in-hospital mortality was similar (5%), with more women diagnosed with atrial fibrillation and heart failure at follow-up. Conclusions Women had a higher prevalence of risk factors affecting the presentation and morbidity but not mortality. Improving these risk factors and the lifestyle is a priority to improve the outcome and decrease morbidity.

scholarly journals Gender differences in patients presenting with NSTEMI in the STAR registry

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
A Meer ◽  
A Kinsara
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Epigastric Pain ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Female Group ◽  
St Segment Elevation ◽  
Male Group ◽  
The Mean

Abstract Funding Acknowledgements Type of funding sources: None. Background  In most acute coronary artery (ACS) related literature, the female gender constitutes a smaller proportion compared to the male gender. The presentation of ACS in females is frequently atypical, causing a delay in diagnosis and management. This study is based on gender-specific data in the Saudi Acute Myocardial Infarction Registry Program (STARS-1 Program). Methods  A prospective multicenter study, conducted with patients diagnosed with ACS in 50 participating hospitals. Results  In total, 762 (34.12%) patients were diagnosed with Non ST segment Elevation Myocardial infarction Of this group, only 164 (21.52%) were women. The mean age of the female group (64.52 ± 12.56 years) was older and the mean body mass index (BMI) was higher (30.58 ± 6.23) than the male group. A significantly higher proportion of the female group was diabetic or hypertensive, however, a smaller proportion was smoking. Hyperlipidemia was not significant between the two groups, although present in almost half (48%) of the female group. The history of angina/MI/stroke and revascularization was similar, except for renal impairment. The presentation was atypical compared to the male group as only 70% presented with chest pain, and the rest with shortness of breath or epigastric pain. At presentation, the female group were more tachycardiac, had higher blood pressure, and a higher incidence of being in class 11-111 Killip heart failure. Only 32% had a normal systolic function, and the majority had either mild or moderate systolic dysfunction. Guideline directed medical therapy were not different between the two groups, except for the initiation of a beta-blocker on admission. In particular, the rate of percutaneous coronary intervention (PCI) was similar. Overall, the in-hospital mortality was similar (5%), with more women diagnosed with atrial fibrillation and heart failure at follow-up. Conclusion  Women had a higher prevalence of risk factors affecting the presentation and morbidity but not mortality. Improving these risk factors and the lifestyle is a priority to improve the outcome and decrease morbidity.

scholarly journals Gender differences in patients presenting with NSTEMI in the STAR registry

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Meer ◽  
A Kinsara
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Epigastric Pain ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Female Group ◽  
St Segment Elevation ◽  
Male Group ◽  
The Mean

Abstract Funding Acknowledgements Type of funding sources: None. Background  In most acute coronary artery (ACS) related literature, the female gender constitutes a smaller proportion compared to the male gender. The presentation of ACS in females is frequently atypical, causing a delay in diagnosis and management. This study is based on gender-specific data in the Saudi Acute Myocardial Infarction Registry Program (STARS-1 Program). Methods  A prospective multicenter study, conducted with patients diagnosed with ACS in 50 participating hospitals. Results  In total, 762 (34.12%) patients were diagnosed with Non ST segment Elevation Myocardial infarction Of this group, only 164 (21.52%) were women. The mean age of the female group (64.52 ± 12.56 years) was older and the mean body mass index (BMI) was higher (30.58 ± 6.23) than the male group. A significantly higher proportion of the female group was diabetic or hypertensive, however, a smaller proportion was smoking. Hyperlipidemia was not significant between the two groups, although present in almost half (48%) of the female group. The history of angina/MI/stroke and revascularization was similar, except for renal impairment. The presentation was atypical compared to the male group as only 70% presented with chest pain, and the rest with shortness of breath or epigastric pain. At presentation, the female group were more tachycardiac, had higher blood pressure, and a higher incidence of being in class 11-111 Killip heart failure. Only 32% had a normal systolic function, and the majority had either mild or moderate systolic dysfunction. Guideline directed medical therapy were not different between the two groups, except for the initiation of a beta-blocker on admission. In particular, the rate of percutaneous coronary intervention (PCI) was similar. Overall, the in-hospital mortality was similar (5%), with more women diagnosed with atrial fibrillation and heart failure at follow-up. Conclusion: Women had a higher prevalence of risk factors affecting the presentation and morbidity but not mortality. Improving these risk factors and the lifestyle is a priority to improve the outcome and decrease morbidity.

scholarly journals In-hospital and 30-day major adverse cardiac events in patients referred for ST-segment elevation myocardial infarction in Dhaka, Bangladesh

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zubair Akhtar ◽  
Mohammad Abdul Aleem ◽  
Probir Kumar Ghosh ◽  
A. K. M. Monwarul Islam ◽  
Fahmida Chowdhury ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Multivariate Analysis ◽  
Cardiac Events ◽  
Post Discharge ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events

Abstract Background There is a paucity of data regarding acute phase (in-hospital and 30-day) major adverse cardiac events (MACE) following ST-segment elevation myocardial infarction (STEMI) in Bangladesh. This study aimed to document MACE during the acute phase post-STEMI to provide information. Methods We enrolled STEMI patients of the National Institute of Cardiovascular Disease, Dhaka, Bangladesh, from August 2017 to October 2018 and followed up through 30 days post-discharge for MACE, defined as the composite of all-cause death, myocardial infarction, and coronary revascularization. Demographic information, cardiovascular risk factors, and clinical data were registered in a case report form. The Cox proportional hazard model was used for univariate and multivariate analysis to identify potential risk factors for MACE. Results A total of 601 patients, mean age 51.6 ± 10.3 years, 93% male, were enrolled. The mean duration of hospital stay was 3.8 ± 2.4 days. We found 37 patients (6.2%) to experience an in-hospital event, and 45 (7.5%) events occurred within the 30 days post-discharge. In univariate analysis, a significantly increased risk of developing 30-day MACE was observed in patients with more than 12 years of formal education, diabetes mellitus, or a previous diagnosis of heart failure. In a multivariate analysis, the risk of developing 30-day MACE was increased in patients with heart failure (hazard ratio = 4.65; 95% CI 1.64–13.23). Conclusions A high risk of in-hospital and 30-day MACE in patients with STEMI exists in Bangladesh. Additional resources should be allocated providing guideline-recommended treatment for patients with myocardial infarction in Bangladesh.

scholarly journals In-hospital and 30-day major adverse cardiac events in patients referred for ST-segment elevation myocardial infarction in Dhaka, Bangladesh

2020 ◽  
Author(s):  
Zubair Akhtar ◽  
Mohammad Abdul Aleem ◽  
Probir Kumar Ghosh ◽  
A.K.M. Monwarul Islam ◽  
Fahmida Chowdhury ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Multivariate Analysis ◽  
Cardiac Events ◽  
Post Discharge ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events

Abstract Background: There is a paucity of data regarding acute phase (in-hospital and 30-day) major adverse cardiac events (MACE) following ST-segment elevation myocardial infarction (STEMI) in Bangladesh. This study aimed to document MACE during the acute phase post-STEMI to provide information.Methods: We enrolled STEMI patients of the National Institute of Cardiovascular Disease, Dhaka, Bangladesh, from August 2017 to October 2018 and followed up through 30 days post-discharge for MACE, defined as the composite of total death, myocardial infarction, and coronary revascularization. Demographic information, cardiovascular risk factors, and clinical data were registered in a case report form. The Cox proportional hazard model was used for univariate and multivariate analysis to identify potential risk factors for MACE.Results: A total of 601 patients, mean age 51.6±10.3 years, 93% male, were enrolled. The mean duration of hospital stay was 3.8±2.4 days. We found 37 patients (6.2%) to experience an in-hospital event, and 45 (7.5%) events occurred within the 30 days post-discharge. In univariate analysis, a significantly increased risk of developing 30-day MACE was observed in patients with more than 12 years of formal education, diabetes mellitus, or a previous diagnosis of heart failure. In a multivariate analysis, the risk of developing 30-day MACE was increased in patients with heart failure (hazard ratio = 4.65; 95% CI, 1.64–13.23).Conclusions: A high risk of in-hospital and 30-day MACE in patients with STEMI exists in Bangladesh. Additional resources should be allocated providing guideline-recommended treatment for patients with myocardial infarction in Bangladesh.

scholarly journals Analysis of risk factors for different subtypes of acute coronary syndrome

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110083
Author(s):  
Lei Zhang ◽  
Juledezi Hailati ◽  
Xiaoyun Ma ◽  
Jiangping Liu ◽  
Zhiqiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Brain Natriuretic Peptide ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Amino Terminal ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Aims To investigate the different risk factors among different subtypes of patients with acute coronary syndrome (ACS). Methods A total of 296 patients who had ACS were retrospectively enrolled. Blood and echocardiographic indices were assessed within 24 hours after admission. Differences in risk factors and Gensini scores of coronary lesions among three groups were analyzed. Results Univariate analysis of risk factors for ACS subtypes showed that age, and levels of fasting plasma glucose, amino-terminal pro-brain natriuretic peptide, and creatine kinase isoenzyme were significantly higher in patients with non-ST-segment elevation myocardial infarction (NSTEMI) than in those with unstable angina pectoris (UAP). Logistic multivariate regression analysis showed that amino-terminal pro-brain natriuretic peptide and the left ventricular ejection fraction (LVEF) were related to ACS subtypes. The left ventricular end-diastolic diameter was an independent risk factor for UAP and ST-segment elevation myocardial infarction (STEMI) subtypes. The severity of coronary stenosis was significantly higher in NSTEMI and STEMI than in UAP. Gensini scores in the STEMI group were positively correlated with D-dimer levels (r = 0.429) and negatively correlated with the LVEF (r = −0.602). Conclusion Different subtypes of ACS have different risk factors. Our findings may have important guiding significance for ACS subtype risk assessment and clinical treatment.

scholarly journals OUTCOME OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION ARRIVING IN ARMY CARDIAC CENTER LAHORE

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S781-86
Author(s):  
Khurram Shahzad ◽  
Jahanzab Ali ◽  
Ayaz Ahmad ◽  
Ahmad Usman ◽  
Amna Rashdi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Cardiac Center

Objective: To evaluate the feasibility and outcomes of primary percutaneous coronary intervention (PCI) as a mode of treatment in acute ST segment elevation myocardial infarction (STEMI). Study Design: Descriptive cross sectional study. Place and Duration of Study: The study was conducted in Army Cardiac Center Lahore, from Nov 2019 to Feb 2020. Methodology: All patients diagnosed as acute ST-segment elevation myocardial infarction during the study period were offered primary percutaneous coronary intervention among treatment options. Patients who chose primary percutaneous coronary intervention were included in the study. Informed consent was taken. Patient demographics, risk factors, time variables, procedural characteristics and in-hospital adverse events were evaluated. Results: On admission, Out of 50, 30 (60%) of the patients were current smokers, 25 (50%) were hypertensive, 22 (44%) were diabetic, and 1 (2%) had cardiogenic shock. The mean time from symptom onset to hospital arrival was 5 hours and the mean door-to-balloon time was 34 minutes. Culprit coronary artery was the left anterior descending artery (LAD) in 56% cases and multi-vessel disease was present in 38% cases. Primary percutaneous coronary intervention involved balloon dilatation (2%) and stent implantation (98%). The incidence of postprocedural angiographic no-reflow was 0%. All-cause mortality was 1%. Conclusion: This study has shown efficiency, feasibility and safety in performing of primary percutaneous coronary intervention with excellent outcomes in Army Cardiac Center Lahore. In order to further improve its outcomes, our goal should be to decrease reperfusion time which can be achieved by reducing patient delay, increasing public awareness and improving the management of first medical contact.

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