Profile of Acute Coronary Syndrome In Young People: A Hospital Based Observational Study in Western Nepal

Introduction: Acute coronary syndrome is associated with high mortality and morbidity. The incidence of acute coronary events in young is increasing.Objectives: This study aimed at evaluating the profile of acute coronary syndrome in young people in the western part of Nepal.Methodology: A retrospective study was designed. All patients admitted for acute coronary syndromes were taken and data of acute coronary syndrome involving patients aged less than 45 years from April 2015 through December 2017 were collected in a pre-structured proforma and analyzed.Results: There were 712 (489 males and 223 females with M:F=2.19:1) acute coronary syndrome patients admitted during the study period. Only 79 (12.9%) patients were patients <45 years of age. Commonest risk factor of acute coronary syndrome was smoking (69%) followed by dyslipidemia (46.8%), hypertension (45.5%) and diabetes (14%). Out of 79 patients of young acute coronary syndrome, 37 (46.8%) presented with ST elevated myocardial infarction, 16 (20.2%) with non-ST elevated myocardial infarction and 26 (32.9%) with unstable angina. Most common finding in coronary angiography was single vessel disease (35%) –left anterior descending artery being the commonest (53% of single vessel disease), double vessel disease (17.7%), non-critical coronary artery disease (16.4%), triple vessel disease (7.6%) and left main (1.2%). Myocardial bridging was seen in 1.2% and 20% had normal coronaries. Comparison of males and females in different categories of acute coronary showed that males predominate significantly in ST elevated myocardial infarction (odds ratio: 2.99; p=0.03) but there was no significant difference between the males and females presenting either with Non ST elevated myocardial infarction or unstable angina.Conclusion: Acute coronary syndrome in young people was common (12.9%) particularly males with Non ST elevated myocardial infarction. Smoking was the commonest risk factor. Public awareness regarding stoppage of cigarette smoking should be focused to prevent such events especially in the young population. BJHS 2018;3(1)5 : 361-365

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The 12-month period prevalence and cardiac manifestations of HIV in patients with acute coronary syndrome at a tertiary hospital in Cape Town, South Africa: a retrospective cross-sectional study

BMC Infectious Diseases ◽

10.1186/s12879-021-06367-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Camilla Pennefather ◽

Tonya Esterhuizen ◽

Anton Doubell ◽

Eric H. Decloedt

Keyword(s):

South Africa ◽

Acute Coronary Syndrome ◽

Risk Factor ◽

Tertiary Hospital ◽

Hiv Positive ◽

Coronary Syndrome ◽

Vessel Disease ◽

Cardiac Manifestations ◽

Single Vessel Disease ◽

Hiv Negative

Abstract Background HIV-positive patients are increasingly being affected by non-communicable diseases such as coronary artery disease (CAD). Data from high-income countries (HICs) indicate that HIV-positive patients have different risk-factor profiles for acute coronary syndrome (ACS) as well as different cardiac manifestations of this syndrome compared to HIV-negative patients. There is limited data from Sub-Saharan Africa (SSA), and particularly from South Africa with the biggest HIV epidemic in the world. The objective of this study was to determine the 12-month period prevalence of HIV in patients with ACS and to compare the risk-factor profile, ACS presentation and management between HIV-positive and HIV-negative adults. Methods We included all patients hospitalised with ACS from 01 January to 31 December 2018 in a tertiary hospital, Tygerberg Hospital, in Cape Town, South Africa. The HIV-status of all patients was determined using routine clinical records. We performed multiple conditional logistic regression on HIV-positive and HIV-negative patients (1:3 ratio) to compare the risk factor profile, ACS presentation and management between the groups. Results Among 889 patients, 30 (3.4%) were HIV-positive (95% confidence interval (CI): 2.3–4.8). HIV-positive patients were younger, more frequently men, and had a lower prevalence of medical comorbidities and a family history of CAD. They were more likely to present with ST-elevation myocardial infarction (STEMI) [odd’s ratio (OR) (95% CI): 3.12 (1.2–8.4)], and have single-vessel disease [OR (95% CI): 3.03 (1.2–8.0)]. Angiographic and echocardiographic data, as well as management, did not differ between the groups. Among HIV-positive patients, 17 (65%) were virally suppressed (HIV viral load < 200 copies/mL) with a median CD4+ count of 271 cells/mm3. The majority (20, 67%) of HIV-positive patients were receiving antiretroviral therapy at the time of the ACS. Conclusions We found an HIV-prevalence of 3.4% (95% CI 2.3–4.8) in adults with ACS in a high endemic HIV region. HIV-positive patients were younger and more likely to present with STEMIs and single-vessel disease, but had fewer CAD risk factors, suggesting additional mechanisms for the development of ACS.

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The 12-month period prevalence and cardiac manifestations of HIV in patients with acute coronary syndrome at a tertiary hospital in Cape Town, South Africa: a retrospective cross-sectional study

10.21203/rs.3.rs-34814/v1 ◽

2020 ◽

Author(s):

Camilla Pennefather ◽

Tonya Esterhuizen ◽

Anton Doubell ◽

Eric H. Decloedt

Keyword(s):

South Africa ◽

Acute Coronary Syndrome ◽

Risk Factor ◽

Tertiary Hospital ◽

Hiv Positive ◽

Coronary Syndrome ◽

Vessel Disease ◽

Cardiac Manifestations ◽

Single Vessel Disease ◽

Hiv Negative

Abstract Background HIV-positive patients are increasingly being affected by non-communicable diseases such as coronary artery disease (CAD). Data from high-income countries (HICs) indicate that HIV-positive patients have different risk-factor profiles for acute coronary syndrome (ACS) as well as different cardiac manifestations of this syndrome compared to HIV-negative patients. There is limited data from Sub-Saharan Africa (SSA), and particularly from South Africa with the biggest HIV epidemic in the world. The objective of this study was to determine the 12-month period prevalence of HIV in patients with ACS and to compare the risk-factor profile, ACS presentation and management between HIV-positive and HIV-negative adults. Methods We included all patients hospitalised with ACS from 01 January to 31 December 2018 in a tertiary hospital, Tygerberg Hospital, in Cape Town, South Africa. The HIV-status of all patients was determined using routine clinical records. We performed multivariate conditional logistic regression on HIV-positive and HIV-negative patients (1:3 ratio) to compare the risk factor profile, ACS presentation and management between the groups. Results Among 889 patients, 30 (3.4%) were HIV-positive (95% confidence interval (CI): 2.3–4.8). HIV-positive patients were younger, more frequently men, and had a lower prevalence of medical comorbidities and a family history of CAD. They were more likely to present with ST-elevation myocardial infarction (STEMI) [odd’s ratio (OR) (95% CI): 3.12 (1.2–8.4)], and have single-vessel disease [OR (95% CI): 3.03 (1.2–8.0)]. Angiographic and echocardiographic data, as well as management, did not differ between the groups. Among HIV-positive patients, 17 (65%) were virally suppressed (HIV viral load < 200 copies/mL) with a median CD4+ count of 271 cells/mm3. The majority (20, 67%) of HIV-positive patients were receiving antiretroviral therapy at the time of the ACS. Conclusions We found an HIV-prevalence of 3.4% (95% CI 2.3–4.8) in adults with ACS in a high endemic HIV region. HIV-positive patients were younger and more likely to present with STEMIs and single-vessel disease, but had fewer CAD risk factors, suggesting additional mechanisms for the development of ACS.

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Assessment Of Lewis Negative Phenotype As A Risk Factor For Multi Vessel Disease In Patients With Acute Coronary Syndrome

Transfusion Clinique et Biologique ◽

10.1016/j.tracli.2021.12.008 ◽

2021 ◽

Author(s):

Raj Bharath ◽

Krishna Kumar Mohanan Nair ◽

Debasish Gupta ◽

Reshma Vijayan Bindhu

Keyword(s):

Acute Coronary Syndrome ◽

Risk Factor ◽

Coronary Syndrome ◽

Vessel Disease ◽

Negative Phenotype

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Exercise-induced precordial ST-segment depression in prior inferior myocardial infarction with single-vessel disease; with special reference to its mechanisms and distinction from multi-vessel disease

International Journal of Cardiology ◽

10.1016/0167-5273(88)90168-4 ◽

1988 ◽

Vol 18 (2) ◽

pp. 223-241 ◽

Cited By ~ 4

Author(s):

Hajime Kataoka ◽

Toshitaka Ohkubo ◽

Kazuhiko Nakamura ◽

Shuji Hashimoto

Keyword(s):

Myocardial Infarction ◽

Special Reference ◽

Inferior Myocardial Infarction ◽

Vessel Disease ◽

Single Vessel ◽

St Segment ◽

Exercise Induced ◽

Single Vessel Disease

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Direct coronary angioplasty in acute myocardial infarction: Outcome in patients with single vessel disease

Journal of the American College of Cardiology ◽

10.1016/0735-1097(90)90621-u ◽

1990 ◽

Vol 15 (3) ◽

pp. 534-543 ◽

Cited By ~ 52

Author(s):

Gregg W. Stone ◽

Barry D. Rutherford ◽

David R. McConahay ◽

Warren L. Johnson ◽

Lee V. Giorgi ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Coronary Angioplasty ◽

Vessel Disease ◽

Single Vessel ◽

Single Vessel Disease

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Prospective comparison of coronary artery remodeling between acute coronary syndrome and stable angina in single-vessel disease: Correlation between C-reactive protein and extent of arterial remodeling

Clinical Cardiology ◽

10.1002/clc.4960260404 ◽

2003 ◽

Vol 26 (4) ◽

pp. 169-172 ◽

Cited By ~ 8

Author(s):

Myeong-Ki Hong ◽

Seong-Wook Park ◽

Cheol Whan Lee ◽

Young-Hak Kim ◽

June-Hong Kim ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Stable Angina ◽

Arterial Remodeling ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Syndrome ◽

Vessel Disease ◽

Prospective Comparison ◽

Single Vessel Disease

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Level of Serum Uric Acid Along with Other Demographic Parameters in Patients with Acute Coronary Syndrome : A Study of 55 Cases from Chittagong

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v13i2.21070 ◽

2014 ◽

Vol 13 (2) ◽

pp. 55-58

Author(s):

Hasan Murad ◽

Rajiv Dey ◽

Md Atiquel Islam Chowdhury ◽

Hridi Hedayet Ullah ◽

Md Abdur Rouf

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Uric Acid ◽

Unstable Angina ◽

Serum Uric Acid ◽

Troponin I ◽

Elevated Serum ◽

Common Finding ◽

Coronary Syndrome

The association between serum uric acid and ischemic heart disease remains controversial and it has been difficult to identify the specific role of elevated serum uric acid because of its association with established cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidaemia and obesity. Our objective was to study the association of serum uric acid level with confirmed cases of Acute Coronary Syndrome i.e. Unstable Angina, Acute Myocardial Infarction(AMI). The study was conducted in Chittagong Medical College (CMC) & University of Science and Technology(USTC) and nearby diagnostic centre. The study was based on Patients with Acute Coronary Syndrome proved by ECG and/or raised serum Troponin I. The aim of the study was to determine the relationship between serum uric acid and Unstable angina or myocardial infacrtion. There were 35% males & 5% females. The mean age of respondent was 50 years and age ranges from 35 to 70 years. In this study 50 cases of diagnosed myocardial infarction were selected and subsequently investigated with ECG, Radiological and Echocardiographic investigations. Increased serum uric acid levels are a common finding in patients with high blood pressure, insulin resistance, obesity and Cardiovascular disease. The clinical findings, chest X-ray and ECG findings of patients with risk factors for myocardial infarction were extensively studied and the findings are consistent with findings stated in textbooks.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21070

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Analysis of distant cardiovascular events depending on the biomarker profile in patients with myocardial infarction

Russian Journal of Cardiology ◽

10.15829/1560-4071-2019-3-24-31 ◽

2019 ◽

Vol 24 (3) ◽

pp. 24-31

Author(s):

A. F. Khamitova ◽

Sh. Z. Zagidullin ◽

I. R. Lakman ◽

D. F. Gareeva ◽

N. Sh. Zagidullin

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Risk Factor ◽

Sudden Death ◽

Cardiovascular Events ◽

Prognostic Value ◽

Pentraxin 3 ◽

Coronary Syndrome ◽

The World ◽

New Biomarkers

Acute coronary syndrome (ACS) and its complications is one of the main reasons of mortality and invalidation in the world. New biomarkers, such as ST2, NT-proBNP и Pentraxin-3 (Ptx-3) present much more opportunities in the diagnostics of diseases and risk of its development.Aim.To investigate standards and “new” biomarkers in different variants of MI and cardiovascular events in 1 year after MI.Material and methods.In 180 patients with MI (61,4±1,7 years) we determined the serum concentration of standard and “new” (ST2, NT-proBNP, Ptx-3) biomarkers in groups with Q/non-Q, STEMI and NSTEMI and the endpoints (MI, strokes, repeated hospitalizations and sudden deaths) in 1 year (384,3±21,2 days) after MI.Results.Patients with Q-MI and STEMI had higher risk of unfavorable cardiovascular events (p<0,05). Ptx-3 >43,9 ng/ml was shown to be risk factor for sudden death (sensitivity 70,0%, specificity 52,9%), and >125,9±0,06 ng/ml (74,1% and 44,1%) — of recurrent MI.Conclusion.NT-proBNP, ST2 and Ptx-3 showed prognostic value in the diagnostics of unfavorable cardiovascular endpoints.

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