Socio-economic Status of the Patients with Acute Coronary Syndrome: Data from a District-level General Hospital of Bangladesh

Background: Several studies have reported the correlation between socio-economic status (SES) and incidence of acute coronary syndrome (ACS). However, none of these studies have included data on Bangladesh. Hence, we aimed to find out the SES among the patients with ACS admitted in a district-level general hospital of Bangladesh.Methods: All the patients with a diagnosis of ACS admitted from March 2016 to February 2017 in the Cardiology department of 250-bedded General Hospital (Abdul Malek Ukil Medical College & Hospital), Noakhali were enrolled in this study. Data on demography, risk factors and SES parameters of the patients was screened and recorded with the help of a pre-defined questionnaire. Socioeconomic profile of the patients was defined according to modified Kuppuswamy SES scale.Results: A total of 366 patients were included (mean age 56.6 ± 11.5 years, 261 male and 105 female). Most of the patients had multiple risk factors like smoking, hypertension, diabetes, dyslipidemia and family history of cardiovascular disease. 80.1% (n=293) of the studied patients were from lower socio-economic class followed by 18.3% (n=67) from middle class and only 1.6% (n=6) were from upper class.Conclusion: This study found that most of the patients admitted due to ACS in a district-level general hospital of Bangladesh are from lower socio-economic class. These findings could be useful to draw the attention of health authorities towards people of lower socio-economic class and to adopt preventive strategies for them against ACS.Cardiovasc. j. 2017; 10(1): 17-20

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Metabolic Risk Factors and Outcomes in Acute Coronary Syndrome

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i130349 ◽

2020 ◽

pp. 46-50

Author(s):

Ritu Attri ◽

Harsimran Kaur ◽

Raminderpal Singh Sibia ◽

Mandip Singh Bhatia

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Positive Family History ◽

Developed Countries ◽

P Value ◽

Health Crisis ◽

Female Ratio ◽

Medical College ◽

Coronary Syndrome ◽

History Of

Introduction: CAD is the most common cause of mortality in India. It is a common multifarious public health crisis today and a leading cause of morbidity and mortality in both developing and developed countries. Hence, understanding the predominant risk factors among the Indian population is important. Materials and Methods: This was a hospital based age and sex matched case control study, carried out at Government Medical College and Rajindra Hospital Patiala. A total of 100 patients of Acute coronary syndrome were studied. Patients and controls were enquired about the presence of cardiometabolic risk factors and the significance of association of these risk factors with the occurrence of Acute coronary syndrome was given by p value of <0.05. Results: Majority of the cases were in the age group 61-70 years (32%) with male to female ratio of 1.25:1. Significant association was found between ACS and risk factors like smoking, positive family history of IHD, hypertension, diabetes, dyslipidemia, waist hip ratio and body mass index. Overall, most common outcome of ACS in the present study was NSTEMI (45%) followed by STEMI (35%) followed by Unstable angina (20%). Conclusion: Significant association was found between smoking and occurrence of STEMI and significant association was found between Hypertension and occurrence of NSTEMI.

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Emotional triggering and low socio-economic status as determinants of depression following acute coronary syndrome

Psychological Medicine ◽

10.1017/s0033291710002588 ◽

2011 ◽

Vol 41 (9) ◽

pp. 1857-1866 ◽

Cited By ~ 21

Author(s):

A. Steptoe ◽

G. J. Molloy ◽

N. Messerly-Bürgy ◽

A. Wikman ◽

G. Randall ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Emotional Stress ◽

Low Income ◽

Rating Scale ◽

Economic Status ◽

Depression And Anxiety ◽

Coronary Syndrome ◽

Socio Economic Status ◽

Acute Emotional Stress ◽

Increased Risk

BackgroundThe determinants of depression following acute coronary syndrome (ACS) are poorly understood. Triggering of ACS by emotional stress and low socio-economic status (SES) are predictors of adverse outcomes. We therefore investigated whether emotional triggering and low SES predict depression and anxiety following ACS.MethodThis prospective observational clinical cohort study involved 298 patients with clinically verified ACS. Emotional stress was assessed for the 2 h before symptom onset and compared with the equivalent period 24 h earlier using case-crossover methods. SES was defined by household income and education. Depression was measured with the Beck Depression Inventory and the Hamilton Rating Scale for Depression and anxiety with the Hospital Anxiety and Depression Scale 3 weeks after ACS and again at 6 and 12 months. Age, gender, ethnicity, marital status, the Global Registry of Acute Coronary Events risk score, duration of hospital stay and history of depression were included as covariates.ResultsEmotional stress during the 2-h hazard period was associated with increased risk of ACS (odds ratio 1.88, 95% confidence interval 1.01–3.61). Both low income and emotional triggering predicted depression and anxiety at 3 weeks and 6/12 months independently of covariates. The two factors interacted, with the greatest depression and anxiety in lower income patients who experienced acute emotional stress. Education was not related to depression.ConclusionsPatients who experience acute emotional stress during their ACS and are lower SES as defined by current affluence and access to resources are particularly vulnerable to subsequent depression and anxiety.

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Gestational Diabetes Mellitus and Associated Risk Factors in Patients Attending Diabetic Association Medical College Hospital in Faridpur

Journal of Enam Medical College ◽

10.3329/jemc.v7i3.34071 ◽

2017 ◽

Vol 7 (3) ◽

pp. 126-133

Author(s):

Poly Begum ◽

Dipti Rani Shaha ◽

Khalifa Mahmud Walid

Keyword(s):

Risk Factors ◽

Past History ◽

Economic Status ◽

College Hospital ◽

Family History Of Diabetes ◽

Medical College ◽

Socio Economic Status ◽

History Of ◽

Associated Risk Factors ◽

Association Medical

Background: The prevalence of gestational diabetes mellitus (GDM) is increasing all over the world and varies widely depending on the region of the country, dietary habits and socio-economic status. The prevalence of GDM with its associated risk factors has important health complications for both mother and child.Objectives: The aim of this study was to evaluate the prevalence of GDM and risk factors associated with it in women attending Diabetic Association Medical College Hospital in Faridpur for ante-natal care.Materials and Methods: In this cross-sectional study, screening for GDM was performed in 303 pregnant women. Women who consented to participate underwent a standardized 2-hour 75 gm oral glucose tolerance test (OGTT). A proforma containing general information on demographic characteristics, socio-economic status, education level, parity, family history of diabetes and past history of GDM etc. was filled in. American Diabetes Association (ADA) criteria for 75 gm 2-hour OGTT was used for diagnosing GDM.Results: A total of 303 women participated in the study and GDM was diagnosed in 22 (7.3%) women. A single abnormal value was observed in additional 33 (10.89%) women. On bivariate analysis risk factors found to be significantly associated with GDM were age, household income, parity, educational level, socio-economic status, hypertension, BMI, weight gain, acanthosis nigricans, family history of diabetes and past history of GDM; but on multivariate analysis only upper middle class and presence of acanthosis nigricans were found to be significantly associated with GDM.Conclusion: This study demonstrates a high prevalence of GDM in Bangladesh. These estimates for GDM may help for new suggestions to prevent and manage gestational diabetes.J Enam Med Col 2017; 7(3): 126-133

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A Study on Clinical Proﬁle, Risk Factors, Angiographic Proﬁle and Short-Term Mortality of Acute Coronary Syndrome in Smokers vs Non Smokers

Asian Journal of Medical Research ◽

10.47009/ajmr.2020.9.2.me1 ◽

2020 ◽

Vol 9 (2) ◽

pp. 1-5

Author(s):

B V Narayana Reddy ◽

Hemasundar Korrapati ◽

Supraja Chegireddy

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Care Practice ◽

Medical College ◽

Coronary Syndrome ◽

Short Term Mortality ◽

Prevalence Of Obesity ◽

Coronary Syndromes ◽

Socio Demographic Factors ◽

A Prospective Study

Background: Smoking has long been positively associated with the development and progression of coronary heart disease. However, lon- gitudinal cohort studies evaluating smoking habits among cardiac patients as well as the role of socio-demographic factors determining such behaviours are scarce and have been focused on primary care practice. Prevalence of acute coronary syndrome in young individuals is increasing progressively. Previous studies have focused on the analysis of risk factors and to some extent coronary angiographic profile in smokers vs non-smokers patients with acute coronary syndrome. The aim of the study is to study the acute coronary syndrome in smokers versus non-smokers and to analyse with respect to baseline characteristics. Subjects and Methods: It was a prospective study conducted at Department of Cardiology, Katuri Medical College & Hospital Guntur. Results: In the present study, Acute coronary syndrome occurred seven years earlier in smokers compared with non-smokers (p<0.05) Smokers were frequently male subjects compared with non-smokers (p<0.001) Smokers had a lower prevalence of Diabetes compared with non-smokers (p<0.001) Smokers had a higher prevalence of Obesity compared with non-smokers (p<0.001). Smokers presented with more acute infarctions and less Unstable angina compared with non-smokers (P<0.001). Conclusion: In the present study, significant differences were observed in coronary risk factor profile between smokers and non-smokers patients with STEMI and NSTEMI/UA. Larger studies will be required to establish specific associations between presentation of acute coronary syndromes and angiographic profiles in smokers.

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Prevalence of Conventional Risk Factors and Lipid Profiles of Patients with First Day of Acute Coronary Syndrome Admitted in CCU of Gandaki Medical College Teaching Hospital, Pokhara, Nepal

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v9i2.17860 ◽

2017 ◽

Vol 9 (2) ◽

pp. 13-16

Author(s):

Gopi Prasad Hirachan ◽

R Hirachan ◽

BB Thapa ◽

KB Thapa

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Lipid Profile ◽

College Teaching ◽

Medical College ◽

Coronary Syndrome ◽

Number Of Patients ◽

History Of ◽

Time Of Admission ◽

Conventional Risk Factors

Background: Out of the total number of patients admitted in coronary care unit (CCU) with acute coronary syndrome (ACS), 75 - 85% presented with conventional risk factors. On the other hand, lipid profile modification after a cardiovascular event related to acute coronary syndrome has also been recognized. But there are controversies regarding the temporary changes in lipid profile after ACS. In our country, there are limited studies about the basal characteristics of lipid profile and the variability of its components after an ACS.Objectives: 1) To analyze the changes in lipoprotein levels in a group of patients hospitalized with ACS. 2) To describe the basal lipid profile. 3) To find out the prevalence of conventional risk factors of ACS patients.Methods: A total of 300 patients with the diagnosis of ACS were studied and the presence of conventional risk factors including smoking, hypertension, dyslipidemia and diabetes were recorded. In addition, we also analyzed the lipid profile within the first 24 hours of admission and body mass index (BMI) of all the patients included in the study.Results: Among a total of 300 patients, the mean age of men was 45 – 75 years and women 50 – 65 years. There were 47.5% patients with non-STEMI and 52.5% with ST-elevated myocardial infaraction (STEMI). In patients with BMI <24, 23.9% were males and 32.2% females; in patients with BMI 25 - 29, 55.4% were males and 48.7% females and in patients with BMI >30, 20.7% were males and 19.1% females. Among the study population, prior myocardial infaraction (MI) was seen in 29%, prior CABG in 4.2% and 10.5% had family history of CAD. In this study, diabetes and dyslipidemia were more in STEMI whereas dyslipidemia was common in non-STEMI. Among the conventional risk factors, smoking and hypertension were more common in STEMI in both men and women.Conclusions: In all patients admitted in CCU, basal lipid profile should be evaluated at the time of admission for choosing the most adequate treatment.Journal of Gandaki Medical College Volume, 09, Number 2, July December 2016, page: 13-16

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A Study on Angiographic profile of Acute Coronary Syndrome in Smokers

Academia Journal of Medicine ◽

10.47008/ajm.2020.3.1.8 ◽

2020 ◽

Vol 3 (1) ◽

pp. 32-41

Author(s):

Hemasundar Korrapati ◽

B.V. Narayana Reddy ◽

Supraja Chegireddy

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Killip Class ◽

Medical College ◽

Coronary Syndrome ◽

Vessel Disease ◽

Artery Disease ◽

Type 3

Background: Coronary artery disease is a devastating disease precisely because an otherwise healthy person in the prime of life may die or become disabled without warning. The objectives were to study the clinical profile, risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in acute coronary syndrome (ACS) patients admitted in Cardiology Department of Cardiology Katuri Medical College & Hospital, Guntur.Subjects and Methods:A total of 208 patients of ACS were analyzed for various risk factors, angiographic patterns and severity of coronary artery disease in smokers vs non-smokers at Katuri Medical College, Andhra Pradesh.Results:Study group consisted of 208 subjects, of which 108(51.9%) subjects were smokers including all forms of tobacco use and 100(48.1 Out of 108 study subjects in the smokers group, family history of CAD was present in 21(19.4%) subjects. Killip class is not applicable to 13 (12%) study groups as they presented with Unstable Angina with ECG changes. Killip class 1 was most common presentation (67.6%) in smokers. 28 patients (25.9%) had LV dysfunction with EF < 50% by echocardiography. 80 patients (74.1%) had normal LV function. The mean EF was 55.56+/-10.16%. The median EF was 56.5%. LAD was type 3 in 100 (92.6%) patients and type 4 in 8 (7.4%) patients out of 108 study subjects.LAD type 3 was statistically significant with P value < 0.05 when compared with LAD type 4. No statistically significant difference was seen with respect to the Normal coronary arteries as CAG diagnosis between smokers and non-smokers(6.7% versus 8%,p>0.1,Not significant).Conclusion: Smokers were predominantly male and around 3 years younger than non-smokers. Diabetes mellitus and hypertension were less common among smokers and single-vessel disease was the more common angiographic finding for smokers as compared to 3-vessel disease for non-smokers. ST-segment elevation myocardial infarction in smokers despite younger age and the low atherosclerotic risk profile, in our region, emphasize the need for nicotine addiction management and smoking cessation campaigns at large and for pre-discharge counseling.

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Prevalence of Conventional Risk Factors in Acute Coronary Syndrome Patients in Eastern Part of Nepal

Journal of Nobel Medical College ◽

10.3126/jonmc.v6i1.18087 ◽

2017 ◽

Vol 6 (1) ◽

pp. 48-55

Author(s):

Rajesh Nepal ◽

Madhav Bista ◽

Abdul Khaliq Monib ◽

Manoj Kumar Choudhary ◽

Aakriti Bhattarai

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Culprit Lesion ◽

Medical College ◽

Coronary Syndrome ◽

Risk Factor Reduction ◽

High Prevalence ◽

Study Population ◽

Artery Disease ◽

Conventional Risk Factors

Background: Smoking, diabetes mellitus, hypertension and dyslipidemia are known as conventional risk factors of coronary artery disease (CAD) and the prevalence of it varies across populations. There is paucity of data in our country about the prevalence of risk factors for acute coronary syndrome (ACS). This study aims to assess the prevalence of these conventional risk factors in patients who were admitted in Nobel medical college, with the diagnosis of ACS.Material & Methods: In this observational study, we enrolled 102 patients diagnosed as ACS with stenosis ≥50% of any epicardial arteries as shown on angiography admitted in Nobel Medical College between September 2015 to March 2017 and evaluate the prevalence of conventional risk factors. In addition, we analyzed the lipid profiles within 24 hour of the event.Results: Mean age of the patients was 59 years. Two third (66.7%) of the patients were male. Left anterior descending artery (43.13%) was the most common culprit lesion followed by RCA in 35.29%. Dyslipidemia was present in 73.5%, hypertension in 46.1%, smoking in 38.2% and diabetes in 37.3%. Prevalence of hypertension, diabetes and dyslipidemia was similar among male and female. Smoking (44.1%vs26.5%) was more common in male (P=<0.05). TG ≥150 mg/dl was seen in 52% study population and higher level of TG was seen in younger population ≤45 years compared to ≥45 years old (p=0.013).Conclusion: Present study showed high prevalence of hypertension, smoking, diabetes and dyslipidemia in patients with ACS, suggesting the need of aggressive risk factor reduction in general population. Journal of Nobel Medical CollegeVolume 6, Number 1, Issue 10 (January-June, 2017), page: 48-55

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Assessment of the Nutritional Status and Determinants of Malnutrition among School Going Adolescents in the Rural Field Practice Area of the Medical College, Hassan, Karnataka

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2019/v40i230221 ◽

2020 ◽

pp. 1-13

Author(s):

G. Praveen ◽

K. J. Subhashini

Keyword(s):

Risk Factors ◽

Nutritional Status ◽

Sample Size ◽

Economic Status ◽

Significant Risk ◽

Overweight And Obesity ◽

Government School ◽

Medical College ◽

Socio Economic Status ◽

Field Practice

Background and Objectives: Adolescence which is the transitional period between childhood and adulthood is often the neglected phase as the adolescents are often regarded as relatively healthy with the focus being given for children and women. Addressing the nutritional needs of adolescents could be an important step in curbing malnutrition among them. With the rising epidemic of Non-communicable diseases, it is equally important to address both the issues of under-nutrition and over-nutrition. Hence this study was undertaken to assess the nutritional status and associated risk factors of malnutrition among the school going adolescents from 5th to 12th standard in the rural field practice area of Hassan Institute of Medical Sciences (HIMS), Hassan. Methods: A cross-sectional study was conducted among the school going adolescents attending the government and private schools of the rural field practice area of the medical college from January 2017 to June 2018. The sample size of 830 was divided between the three areas under rural field practice area as per sample size proportional to population. BMI was measured and WHO reference charts 2007 for BMI was used to categorize the nutritional status of the adolescents. Results: The prevalence of malnutrition among the school going adolescents was found to be 44.1% of which the prevalence of thinness and severe thinness was 15.8% and 21.3% respectively and that of overweight and obesity was 5.8% and 1.2% respectively. On logistic regression, male gender, government school, lower socio-economic status, deworming status and open-air defecation were identified as significant risk factors for undernutrition and female gender, private school, upper socio-economic status, low levels of physical activity, excess television watching, consuming junk foods, breakfast skipping, inadequate sleeping hours were identified as significant risk factors for over nutrition. Conclusion: The prevalence of malnutrition among the school going adolescents was found to be 44.1% in our study. Gender, type of school in which they study, socio-economic status and life style behaviours were found to be significant risk factors for malnutrition. There is a need for health education programmes, regular monitoring and effective policies to promote healthy eating and lifestyle changes among adolescents to curb the burden of malnutrition.

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A Study of Risk Factors in Young Patients of Acute Coronary Syndrome

Journal of Dhaka Medical College ◽

10.3329/jdmc.v28i1.45748 ◽

2020 ◽

Vol 28 (1) ◽

pp. 3-6

Author(s):

Prodip Kumar Biswas ◽

Md Hafiz Sardar ◽

Gopal Chandra Saha ◽

Mohammad Zaid Hossain ◽

Mohammed Shahadat Hossain ◽

...

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Risk Factor ◽

Troponin I ◽

Sedentary Lifestyle ◽

Young Patients ◽

Modifiable Risk Factor ◽

Premature Coronary Artery Disease ◽

Medical College ◽

Coronary Syndrome

Aim: The study was carried out to see the risk factors of Acute Coronary Syndrome in young patients. Materials and Methods: This is a prospective study which was carried out in 60 young patients (18-40 years of age) with a diagnosis of Acute Coronary Syndrome admitted to Dhaka medical college Hospital, Dhaka. over a period of 02 years from January 2016 to January 2018. Acute Coronary Syndrome was diagnosed by clinical history, ECG evaluation and Serum Cardiac enzyme Troponin I and CK-MB estimation. Result: Most of the patients (73%) had a sedentary lifestyle and 50% had dyslipidemia. 40% patients were taking a diet rich in fats, 37% patients were diabetic, 33% were hypertensive, 37% patients consume oral tobacco, 30% were smokers, 13% were obese and 17% were alcoholics. The family history of premature coronary artery disease was present in only 13% of cases. In our study, none of the patients had consumed oral contraceptive pills. Conclusion: The most important modifiable risk factor is the sedentary lifestyle. The commonest non-modifiable risk factor is Male sex. Smoking, oral tobacco consumption, hypertension, diabetes, dyslipidemia, and diet modification are other important modifiable risk factors in young adults. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 3-6

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