Gender Differences in the Clinical Characteristics of Patients with Acute Coronary Syndrome in the Eastern Region of Nepal

Background: Studies from other regions show gender-based differences in the clinical characteristics of patients with the acute coronary syndrome (ACS) with conflicting results. There is a lack of definite data from our population. Materials and Methods: This is a hospital-based cross-sectional study in patients with ACS admitted to the tertiary care center from January 2019 to June 2020. Risk factors, co-morbidities, clinical symptoms, duration of symptoms onset, modalities of treatment offered, complications, and in-hospital outcome were noted in the pre-structured questionnaire by convenient sampling. Data were analyzed by using Microsoft excel 2007 and SPSS 20. Results: Among 384 participants, 65.9% were male and 34.1% were female. The mean age of males was 60.6 ± 12.1 and females 62.3 ± 11.1 years (P=0.21). Females had a higher prevalence of dyslipidemia (p<0.001). The prevalence of hypertension, diabetes, and smoking was similar. The mean hemoglobin level was higher in males (11.8 ± 2.2 gm/dl vs. 11.1 ± 4.57 gm/dl, P = 0.01). The majority presented with chest pain (94.9%) in males and 87.8% in females, P=0.44), and sweating (76.7% in males and 80.2% in females, P=0.43). Non-anginal symptoms were almost similar in both the genders except nausea which was more common in males (P=0.03). The timing of presentation, treatment with reperfusion therapy, and arterial territory involved were not significantly different. Prevalence of mechanical and arrhythmic complications as well as mortality was similar. Conclusion: Our study did not show significant gender-based differences in clinical profile, treatment modalities, in-hospital complications, and mortality.

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Study of clinical profile of acute coronary syndrome in young adult population at a tertiary care center

Medpusle International Journal of Medicine ◽

10.26611/10211722 ◽

2021 ◽

Vol 17 (2) ◽

pp. 13-17

Author(s):

Mareppa Kattimani ◽

Keyword(s):

Acute Coronary Syndrome ◽

Young Adult ◽

Care Center ◽

Adult Population ◽

Tertiary Care ◽

Clinical Profile ◽

Tertiary Care Center ◽

Coronary Syndrome ◽

Young Adult Population

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Prevalence of Vitamin D Deficiency among Patients of Acute Coronary Syndrome in a Tertiary Care Center of Eastern Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.5166 ◽

2021 ◽

Vol 59 (235) ◽

Author(s):

Richa Nepal ◽

Prahlad Karki ◽

Surendra Uraw ◽

Madhab Lamsal

Keyword(s):

Vitamin D ◽

Acute Coronary Syndrome ◽

Confidence Interval ◽

Vitamin D Deficiency ◽

Care Center ◽

Tertiary Care ◽

Care Hospital ◽

Tertiary Care Center ◽

Hypertensive Patients ◽

Coronary Syndrome

Introduction: Vitamin D deficiency is an emerging risk factor for cardiovascular diseases. Very few studies have been done to find out vitamin D deficiency status among cardiovascular patients in Nepalese setup. This research aims to find out the prevalence of vitamin D deficiency among patients of acute coronary syndrome admitted in a tertiary care center of eastern Nepal. Methods: This was a descriptive cross-sectional study conducted among patients of acute coronary syndrome admitted in a tertiary care hospital from 1st February 2018 to 31st July 2018. Ethical clearence was taken from Institutional Review Committee of B.P. Koirala Institute of Health Sciences (Reference number: 259/074/075-IRC). Convenience sampling method was used. Data was entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 25. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: A total of 33 (64.7%) at 95% Confidence Interval (51.58-77.82) patients of acute coronary syndrome had vitamin D deficiency in our study with 19 (37.3%) having mild deficiency and 14 (27.4%) having moderate deficiency. None of the patients had severe vitamin D deficiency in our study. The mean vitamin D levels were lower in diabetics (23.57Â±9.28ng/ml) as compared to non-diabetics (31.91Â±12.50ng/ml), in hypertensive patients (24.36Â±7.67ng/ml) as compared to non-hypertensive patients (30.97Â±13.72ng/ml), and in patients with dyslipidemia (22.86Â±6.44ng/ml) as compared to those without dyslipidemia (37.68Â±13.15ng/ml). Conclusions: Prevalence of vitamin D deficiency among patients of acute coronary syndrome in our study was comparable to various other homologous international studies.

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Frequency of ABO Blood Group and its Association with Acute Coronary Syndrome in Patients Presenting in a Tertiary Care Center of Nepal

Journal of Institute of Medicine ◽

10.3126/jiom.v42i1.37427 ◽

2020 ◽

Vol 42 (1) ◽

pp. 49-53

Author(s):

Surya R Pathak ◽

Sunil C Jha ◽

Ratna M Gajurel ◽

Chandra M Poudel ◽

Hemant Shrestha ◽

...

Keyword(s):

Coronary Artery Disease ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Blood Group ◽

Care Center ◽

Tertiary Care ◽

Abo Blood Group ◽

Coronary Syndrome ◽

Increased Risk ◽

Artery Disease

Introduction Coronary artery disease is the major cause of death all over the world. There are studies suggesting association between blood group and coronary artery disease. We attempted to study the frequency of ABO blood group and its association with acute coronary syndrome (ACS) in our hospital. MethodsThis is a retrospective, cross sectional study carried out in Manmohan Cardiothoracic Vascular and Transplant Centre from March 2018 to February 2019. Patients who were admitted with diagnosis of ACS were enrolled in the study. Data were recorded and analyzed using SPSS 20. Association between blood group and ACS was analyzed using chi square test and logistic regression. ResultsTotal 430 patients were admitted with diagnosis of ACS during the study period, of which 307 (71.4 %) were male and Mean age was 61.22 years (±10.75). Blood group O was the most common type of blood group observed in 207 (48%) patients. ACS was significantly higher in blood group O compared to other groups after adjusting for normal ABO blood group prevalence in general population: blood group O vs. A (OR: 3.45, 95% CI: 2.48- 4.79, p- <0.001), blood group O vs. B (OR: 5.08, 95% CI: 3.53-7.33, p- <0.001), blood group AB vs. O (OR: 0.65, 95% CI: 0.41- 1.02, p- 0.064). Individuals with blood group O and B had increased risk of having STEMI and NSTEMI where as those with blood group A had increased risk of having unstable angina. ConclusionThere was association between ABO blood group and coronary artery disease. Individuals with blood group O have increased incidence of ACS.

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Delayed Presentation of Acute Coronary Syndrome: A Challenge in its Early Management

Journal of Nepal Medical Association ◽

10.31729/jnma.173 ◽

2009 ◽

Vol 48 (173) ◽

Author(s):

Pramod Acharya ◽

RR Adhikari ◽

J Bhattarai ◽

NR Shrestha

Keyword(s):

Acute Coronary Syndrome ◽

Chest Pain ◽

Care Center ◽

Tertiary Care ◽

Late Presentation ◽

Delayed Presentation ◽

Tertiary Care Center ◽

Early Management ◽

Coronary Syndrome ◽

District Hospitals

INTRODUCTION:The time of presentation of acute coronary syndrome from the onset of chest pain determines the treatment modality and prognosis. Delayed presentation is associated with a poor outcome. In the present study, we tried to find out the causes of late presentation of ACS in a tertiary care center in the eastern part of Nepal.METHODS:It was a cross-sectional descriptive study that included 100 consecutive patients with ACS presenting to our institute over a period of 8 months. They were studied for their demographic profile, delay in presentation, the management done at the local centers and their final diagnosis.RESULTS:We found that patients living within Dharan City reached BPKIHS within 20 hours of the onset of chest pain while those from outside the city who came directly reached within 63 hours. Other patients reached their respective local centers (health posts, district hospitals and private clinics) within 39 hours. The commonest cause of delay was vehicular problem followed by unnecessary delay at the local centers. The work up for chest pain was inadequate in these centers. Late presentation to our institute significantly affected the optimal management.CONCLUSIONS: We found that significant number of patients with ACS from eastern Nepal presented late in our tertiary care center. In order to improve ACS outcome in this region, we advise equipping the local centers with electrocardiogram machines, improvement in ambulance services and a greater emphasis on coronary artery disease awareness programs as well as initiating preventive measures.KEY WORDS:acute coronary syndrome, chest pain, delayed presentation, electrocardiogram

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Evaluation of cardiovascular events and bleeding complications in patients of Acute Coronary Syndrome on various antiplatelet drugs: an observational study in a tertiary care center in Eastern India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20174790 ◽

2017 ◽

Vol 6 (11) ◽

pp. 2695

Author(s):

Anurag Passi ◽

Prashant Kumar ◽

Somnath Mukherjee ◽

Priyanker Mondal ◽

Sankar Chandra Mandal

Keyword(s):

Acute Coronary Syndrome ◽

Observational Study ◽

Stent Thrombosis ◽

Cardiovascular Events ◽

Care Center ◽

Tertiary Care ◽

Bleeding Complications ◽

Minor Bleeding ◽

Male Predominance ◽

Coronary Syndrome

Background: This study is to determine the clinical profile of Acute Coronary Syndrome (ACS) patients, to observe cardiovascular events in patients with ACS undergoing Percutaneous Coronary Intervention (PCI) and to evaluate the bleeding complications with various antiplatelet agents.Methods: This hospital based observational study included patients of ACS presenting between February 2015 to August 2016 who received PCI and were on dual antiplatelet agents.Results: Among 200 patients presenting with ACS mean age was 58.67, there was male predominance and 52.5% presented with STEMI. Cardiovascular death was seen in 2.5% patients and all cause mortality was seen in 3.5% patients. The incidence of Non-fatal myocardial infarction was more in Clopidogrel group (5%) as compared to Prasugrel (4%) and Ticagrelor (2%) group. Non-fatal stroke was seen in 2% patients and incidence was similar in each of the three groups. Incidences of target vessel revascularization (TVR) and stent thrombosis were more in the Clopidogrel group as compared to Prasugrel and Ticagrelor. TIMI Major and Minor bleeding with Prasugrel was higher than clopidogrel and Ticagrelor and TIMI minimal bleeding was seen in 2% patients and was similar in all three groups.Conclusions: Patients receiving clopidogrel has more numbers of CV death, all cause death, non-fatal MI, TVR and stent thrombosis in comparison to the groups receiving Prasugrel or Ticagrelor and on comparing Prasugrel and Ticagrelor, the two drugs are similar in efficacy but, Ticagrelor has better safety outcomes.

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A Comparative Study of Coronary Angiographic Data between Diabetic and Non-Diabetic Patients with Acute Coronary Syndrome

University Heart Journal ◽

10.3329/uhj.v15i1.41444 ◽

2019 ◽

Vol 15 (1) ◽

pp. 34-36

Author(s):

Abu Tarek Iqbal ◽

Md Salehuddin ◽

Md Ayub ◽

Jashimuddin Sada ◽

Khurshed Ahmed

Keyword(s):

Acute Coronary Syndrome ◽

Care Center ◽

Tertiary Care ◽

Age Distribution ◽

Diabetic Patients ◽

Female Ratio ◽

Coronary Syndrome ◽

Total Female ◽

Angiographic Data ◽

History Of

Introduction: Cardiovascular diseases is a major health burden in developing countries like Bangladesh. Patients with acute coronary syndrome(ACS) are at risk for death, myocardial infarction or recurrent ischaemic events. Comorbidity like DM plays a significant role in the outcome of such patients. So the objective of the present study was to see the coronoary angiographic(CAG) findings among diabetic and nondiabetic patients in our context. Methods: Patients presenting with the symptoms of ACS in the Department of Cardiology in a tertiary care center were selected for ECG and cardiac troponin 1. Then according to the defined criteria they was selected for the study. These patients were followed up to their hospital stay period. History of the patient, physical examination and necessary investigations was done. ACS patients were divided into two groups. 1. ACS with DM and 2. ACS without DM. CAG was done among those patients with ACS. Finally CAG findings in two groups were compared systematically. Data were analyzed by SPSS 20. Results: Among the 200 patients total male were 80.5% and total female were 19.5%). Male to female ratio was 5:1. Regarding age distribution it was found matched in both groups. Most patients were at age group 41-50 and 51-60 years which was 31% and 45% respectively. Regarding presence of hypertension in both groups, diabetic group had more hypertensive patients(81%) than the nondiabetic(71%) group (p-0.098). Regarding analysis of CAG findings in diabetic and non diabetic groups LMCA involvement was 16% and 12%, LAD 32% and 28%, LCX 22% and 23%, RCA 23% and 20% and triple vessel was 15% and 14% respectively. Only 5(2.5%) patients were found not to having any lesion. Conclusions: ACS with or without DM has variable CAG findings. So special care should be taken when dealing with such cases. University Heart Journal Vol. 15, No. 1, Jan 2019; 34-36

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TO EVALUATE THE PLATELET FUNCTION IN PATIENTS OF ACUTE CORONARY SYNDROME RECEIVING DUALANTI-PLATELET THERAPY

10.36106/ijsr/0219534 ◽

2021 ◽

pp. 55-57

Author(s):

Shivesh Sahai ◽

Mainak Mukhopadhyay ◽

Auriom Kar ◽

Manoranjan Mandal ◽

Sukanya Banerjee

Keyword(s):

Acute Coronary Syndrome ◽

Platelet Function ◽

Early Stage ◽

Minimum Weight ◽

Tertiary Care ◽

Maximum Height ◽

Care Hospital ◽

Coronary Syndrome ◽

Study Population ◽

The Mean

INTRODUCTION: Cardiovascular diseases are one of the leading cause of death in the world. Several factors have led to the increase in vascular disorders, including the aging population, unhealthy lifestyles, increasing rates of diabetes and raised lipids, and further risk factors resulting in inammation and calcication of the vascular endothelium. Activated platelets in damaged blood vessels can trigger arterial thrombus formation, leading to vascular occlusion with subsequent organ hypoperfusion and clinical manifestation of myocardial infarction, stroke, or peripheral artery disease.AIMS AND OBJECTIVES: To evaluate platelet function in patients of Acute Coronary Syndrome 12hrs after loading dose of dual antiplatelet agents and evaluate platelet function in patients of Acute Coronary Syndrome on maintenance dose of dual anti-platelet agents in steady state. MATERIALS AND METHODS: 41 Adult Patients of both sexes admitted in Department of Cardiology, NRS Medical College and Hospital, a tertiary care hospital from 1ST FEBRUARY 2016 TO 31ST JULY 2017 (18months). RESULTAND ANALYSIS: In our study 51.2% were hypertensive. The study population were varied when it comes to occupation. Our study population consisted of 56.1% smokers and 43.9% non-smokers. The mean height of the study population was 165.8 cm. The maximum height was 180cm. The minimum height was 150cm. The mean weight of the study population was 61.36kg. The maximum weight was 76kg. The minimum weight was 49kg. The mean BMI was 22.36. The maximum was 27.77. The minimum was 18.56. Our study population consisted of 51.2% patients of Type II Diabetes Mellitus. CONCLUSION: This study was undertaken to assess the extent of Aspirin and Clopidogrel non-resposiveness in patients of Acute Coronary Syndrome. If non-responders are detected early particularly Clopidogrel non-responders, we can change the outcome with change of P2Y12 receptor antagonist at an early stage. Although most of the recent guidelines do not recommend routine platelet function testing but almost all studies show a strong association.

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