scholarly journals Age-Related Alteration of Risk Profile, Inflammatory Response, and Angiographic Findings in Patients with Acute Coronary Syndrome

2009 ◽  
Vol 3 ◽  
pp. CMC.S2118 ◽  
Author(s):  
Hala Mahfouz Badran ◽  
Mohamed Fahmy Elnoamany ◽  
Tarek Salah Khalil ◽  
Mostafa Mohamed Ezz Eldin
Keyword(s):  
Inflammatory Response ◽  
Age Groups ◽  
Young Patients ◽  
Risk Profile ◽  
High Morbidity ◽  
Cardiac Enzymes ◽  
Coronary Syndrome ◽  
Group I ◽  
Hs Crp ◽  
Angiographic Findings

Background Coronary artery disease (CAD) is a major public health problem which in turn imposes a significant burden on health care systems because of high morbidity and mortality. Although the multifactorial etiology of CAD increases with age, but in recent years, the incidence is increasing among younger age groups. Objectives In this study we aimed to evaluate the effect of age on risk profile, inflammatory response and the angiographic findings in patients with ACS. Patients and Methods The study comprised 253 ACS patients. Seventy six (30%) with UA, 56 (22%) with NSTEMI and 121(48%) with STEMI diagnosis. The value of Hs-CRP, lipid profile, cardiac enzymes, risk factors, EF% and angiographic score were analyzed and compared in different age groups. Results Group 1 (n = 68) with age <45 years, group II (n = 110) with age ≥45-<65 years and group III (n = 75) ≥65 years. Group I had more prevalence of male sex, smoking, family history, hypertriglyceridemia and low levels of HDL (P < 0.01), higher incidence of STEMI (P < 0.01) and lower prevalence of UA (P < 0.01). Diabetes mellitus, hypertension, and female gender were more common in older groups. Hs-CRP was significantly lower in the young age (group I). Group I showed a preponderance of single-vessel disease, lower coronary atherosclerotic score and prevalent left anterior descending artery (LAD) involvement compared with older age groups. Hs-CRP was positively correlated to severity of CAD only in older groups. Stepwise multiple regression analysis showed that age, male gender, cardiac enzymes and EF% were common predictors of multivessel disease. Smoking was independent predictor in young patients <45 years while diabetes and Hs-CRP was the key predictor in older patient groups. Conclusion Young patients with ACS had different clinical, angiographic and biochemical profile. Hs-CRP peak concentration did not correlate with angiographic findings in young patients that could be attributed to different risk profile and discrete underlying mechanism.

scholarly journals Familial hypercholesterolemia in acute coronary syndrome patients: underdiagnosis in female and in young patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
P Garcia Bras ◽  
G Portugal ◽  
A Castelo ◽  
V Ferreira ◽  
R Teixeira ◽  
...  
Keyword(s):  
Familial Hypercholesterolemia ◽  
Age Groups ◽  
Young Patients ◽  
Hospitalization Rate ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Gender And Age ◽  
Tertiary Center ◽  
All Cause Mortality

Abstract Introduction Familial hypercholesterolemia (FH) is often underdiagnosed, particularly in female patients (P), even during hospital admission for acute coronary syndromes (ACS). The aim of this study was to apply the Dutch Lipid Clinic Network (DLCN) Criteria in P admitted for ACS and evaluate gender and age differences. Methods Prospective evaluation of P with ACS admitted to a tertiary center from 2005 to 2019. Data including family history and laboratory tests was analysed for the application of the DLCN criteria and results were stratified according to ACS subtype, gender and age groups (20–39, 40–59, 60–79 and ≥80 years [y]). P were followed up for 30 days for hospitalization, recurring ACS and mortality. Results 3811 P were evaluated, mean age 63±13 years, 28% female and mean LDL cholesterol of 125±43 mg/dL. The admission diagnosis was unstable angina (UA) in 5%, non-ST-segment elevation myocardial infarction (NSTEMI) in 27% and ST-segment elevation MI (STEMI) in 68%. Applying the DLCN criteria, 3089 P (81%) had a score of &lt;3 (unlikely FH), 675P (17.7%) a score of 3 to 5 (possible FH), 41P (1.1%) a score of 6 to 8 (probable FH) and 1P (0.03%) a score of &gt;8 (definite FH). Stratifying according to ACS type: among UA, 31P (16%) had possible FH and 4P (2.1%) had probable FH. Among NSTEMI, 145P (14.2%) had possible FH, 9P (0.9%) probable FH and 1P (0.03%) definite FH. Finally, among STEMI P, 497P (19.1%) had possible FH and 28P (1.1%) probable FH. Regarding female P, 158P (14.7%) had possible FH and 16 P (1.5%) probable FH. Among male P, 517P (18.9%) had possible FH and 25P (0.9%) probable FH (p=0.016 for interaction). According to age groups, among P aged 20–39 y (136P), 61P (44.9%) had possible FH and 6P (4.4%) had probable FH. Concerning P aged 40–59 y (1766P), 575P (32.6%) had possible FH, 31 P (1.8%) probable FH and 1P (0.1%) definite FH. With regard to P aged 60–80 y (2122P), 80P (3.8%) had possible FH and 4P (0.2%) probable FH. Among P aged ≥80 y (1837P), only 9P (0.5%) had possible FH and no P had probable FH. In a 30-day follow-up, there was an hospitalization rate of 3.5% (134P) and recurring ACS in 1.7% (65P), while the all-cause mortality was 2% (78P) and cardiovascular (CV) death was 1.3% (49P). Female P had a significantly lower hospitalization rate (1.8% vs 3.2%, p=0.003) as well as fewer recurring ACS (0.6% vs 1.7%, p=0.001). There was no significant gender difference regarding all-cause mortality (female 1.7% vs 1.5%, p=0.552) or CV death (0.8% vs 1.1%, p=0.323). The DLCN criteria score was significantly correlated with admission for recurring ACS (OR 1.19 [95% CI 1.04–1.36], p=0.04). Conclusion Application of the DLCN criteria in female P admitted for ACS revealed 158P (14.7%) with possible FH and 16P (1.5%) with probable FH. Regarding younger ACS P (20–39y), 44.9% had criteria for possible FH and 4.4% for probable FH, prompting us to do not overlook these P subgroups in daily practice and routinely assess the likelihood of FH. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals IMPACT OF GENDER ON THE CLINICAL FEATURES, ANGIOGRAPHIC FINDINGS, AND OUTCOMES OF YOUNG PATIENTS PRESENTED WITH ACUTE CORONARY SYNDROME

2022 ◽  
Vol 54 (4) ◽  
pp. 321-327
Author(s):  
Kamran Ahmed Khan ◽  
Dileep Kumar ◽  
Ayaz Hussain Shaikh ◽  
Sanam Khowaja ◽  
Mehboob Ali ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Symptom Onset ◽  
Young Patients ◽  
Cross Sectional ◽  
Men And Women ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Angiographic Findings

Objectives: Acute coronary syndrome (ACS) at a younger age is now becoming a crucial problem. This study determined the effect of gender on the clinical findings and outcomes of young patients (≤ 45 years) with ACS. Methodology: In this descriptive cross sectional study, young patients (≤45 years) who presented with ACS and underwent coronary angiography were recruited. The comparison of clinical profile, angiographic findings, in-hospital, and 90-days mortality between genders were made. Results: A total of 335 young patients with ACS were included, 80.6% of whom were men. A significant difference was found between men and women in terms of mean age: 38±6 vs. 40±5 (p=0.014), hypertension: 37.8% vs. 58.5% (p=0.002), diabetes: 17.4% vs. 35.4% (p=0.001), smoking: 50.4% vs. 6.2% (p≤0.001), use of smokeless tobacco: 14.1% vs. 4.6% (p=0.037), median time from symptom onset to first medical contact: 270 [420–165] minutes vs. 346 [499.5–240] minutes (p=0.047), ST-segment elevation myocardial infarction (STEMI) 89.6% vs. 78.5% (p=0.015), non-ST-elevation myocardial infarction (NSTEMI) 8.5% vs. 18.5% (p=0.019), and three-vessel disease (3VD) 10.7% vs. 21.5% (p=0.019), respectively. In-hospital and 90-day mortality rates were 0.4% vs. 3.1% (p=0.097) and 1.5% vs. 4.6% (p=0.136) for men and women, respectively. Conclusion: Women tended to have a higher age at presentation, more frequent traditional risk factors, late presentation after symptom onset, frequent NSTEMI, and 3VD, whereas men were distinct with frequent STEMI and higher tobacco use. In addition, women trended to have a higher in-hospital as well as short-term mortality than men did.

scholarly journals Characteristic of the coronary vascular system, structural and functional state of the heart and endothelium-dependent vasodilation in young patients with acute coronary syndrome and ST elevation

2019 ◽  
Vol 26 (3) ◽  
pp. 35-44
Author(s):  
O. M. Parkhomenko ◽  
Ya. M. Lutay ◽  
O. I. Irkin ◽  
D. O. Bilyi ◽  
A. O. Stepura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vascular System ◽  
Age Groups ◽  
Young Patients ◽  
Coronary Syndrome ◽  
Elder Patients ◽  
St Elevation ◽  
Artery Disease

The aim – to reveal features of the coronary vascular system, structural and functional state of the heart and endothelium-dependent vasodilatation in ST-elevation acute coronary syndrome (STEMI) patients of different age groups. Materials and methods. We analyzed the data of instrumental examination of patients who were admitted to the emergency departments from 2000 to 2015, with STEMI. Patients were distributed into two groups depending on age: 1 group – patients < 45 years, 2 group ≥ 45 years. Coronary angiography (CAG) was performed within the first hours after the admission. Endothelium-dependent, flow-mediated vasodilation (FMD) test and echocardiography were performed within 24 hours of admission and again on the 7th day. Results and discussion. According to сoronary angiography, elder patients were more likely to have infarction-dependent coronary artery disease (33.3 vs. 20.3 %; p=0.037), and multi-vessel coronary artery disease (12.0 vs. 4.8 %; p=0.048). Patients in the 1st group demonstrated a lower frequency of hemodynamically significant lesions of coronary vessels (p<0.001) and less marked disorders of the lipid spectrum. Patients of the group 1 had less thickness of the interventricular septum. 10.7±1.5 mm versus 11.6±1.6 mm, p=0.024). Young patients had initially better diastolic function (Е/А) (1.29±0.40 versus 1.00±0.52, p=0.008). At day 7 in patients of the 1st group there was a more marked increase in the left ventricular ejection fraction and end-diastolic diastolic index of the left ventricle (7.6 versus 3.4 %; p<0.05) than in the patients of the 2nd group. Young patients demonstrated a tendency to increase of end-diastolic index > 10 %, in dynamics, at 39.7 versus 27.8 % elder patients (p=0.053), lower growth of the diameter of the brachial artery (4.7±4.1 vs. 6.7±5.1 %; p<0.05), but more rapid improvement of endothelial function in the dynamics of observation (104 vs. 23 %; p<0.05). Conclusions. The percentage of damage of coronary artery disease in STEMI young patients did not differ from elder patients but insignificant coronary artery stenosis is detected more often (р<0.001) and acute myocardial infarction in the right coronary artery is less common (р<0.037). Young patients with multi-vessel coronary disease have significant violations of the lipid blood spectrum (increased levels of total cholesterol, low density lipoprotein cholesterol). Indicators of intracardiac hemodynamic did not differ between age groups initially, however, the course of acute myocardial infarction in young patient was characterized by the tendency to develop early post-infarction dilatation (p=0.053). According to the FMD test young patients at the onset had a worse indicator of than elder patients (p<0.043), however the diameter of the brachial artery in the dynamics of observation, significantly increased (p<0.05).

scholarly journals A surge in prevalence and factors affecting early onset acute coronary syndrome

2021 ◽  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Smokeless Tobacco ◽  
Early Onset ◽  
Young Patients ◽  
Adult Patients ◽  
Study Cohort ◽  
Group Iii ◽  
Coronary Syndrome ◽  
Group I

Acute coronary syndrome (ACS) with early onset of age (especially in <30 years) is an infrequent (up to 0.05 to 0.4%) but serious entity, with modest available data. A rise in incidence has been witnessed, especially in South Asia. The aim was to ascertain the proportion of very young patients (≤35 years) among all adult patients with ACS and important factors associated with it. Patients presenting with ACS during September 2020 to January 2021 were incorporated in this cross-sectional single-center study and were analyzed by age: Group I (20–35 years), Group II (36–45 years), and Group III (＞45 years). Demographic characteristics, angiographic findings, co-morbidities and treatment strategies were recorded. 1314 patients with ACS in the study period were examined. Patients in Group I accounted for 6.2% (81) of the study cohort. Of these, 2.1% (28) were aged 20 to 30 years and 4.03% (53) were aged 30 to 35 years. Analysis of age groups by ACS risk factors revealed that male gender, overweight, smoking, using smokeless tobacco (especially gutka), were significantly higher in Group I. Other conventional risk factors were more prevalent in Group III. In Group 1, anterior wall myocardial infarction, single vessel coronary artery disease (SVCAD) and re-canalized vessels were significantly more frequent. Significantly higher proportion of patients were treated with conservative management alone in Group I. In our crossectional study we report an inclining shift in the frequency of early onset ACS than previously observed. In this recent cohort, ACS in the youngest adult patients was significantly associated with being overweight, smoking, and smokeless tobacco use, especially gutka. Moreover, these patients’ higher rates of SVCAD and re-canalized vessels due to hypercoagulable milieu, could be better responsive to aggressive pharmacologic treatment noted in these young patients.

scholarly journals Features of laboratory-diagnostic indicators in patients of different age groups with ST-elevation acute coronary syndrome

2019 ◽  
Vol 26 (1) ◽  
pp. 31-39 ◽  
Author(s):  
O. M. Parkhomenko ◽  
Ya. M. Lutay ◽  
D. O. Bilyi ◽  
O. I. Irkin ◽  
A. O. Stepura ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Familial Hypercholesterolemia ◽  
Age Groups ◽  
Young Patients ◽  
Significant Risk ◽  
Young Age ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome ◽  
Observation Period

The aim – to find out the features of laboratory diagnostic indicators in patients of different age groups with ST-elevation acute coronary syndrome. Materials and methods. Were analyzed the data of 835 patients admitted to the emergency departments from January 2000 to December 2015, with ST-elevation acute coronary syndrome. Patients were divided into the two groups depending on age: I group – patients <45 years of age (n=189), II group ≥ 45 years (n=646). Results and discussion. In young patients, hemoglobin and platelet levels were significantly higher throughout the observation period. Initial ALT and AST were significantly higher in young patients on day 1 (p<0.001 and p<0.01, respectively), but didn’t differ further. Baseline glucose level in patients <45 years of age was significantly lower than in the older group (p<0.05). Patients <45 years had higher values of fibrinogen (p=0.048). Young adults had lower total cholesterol, LDL at baseline (p<0.05) and the day 7 (p<0.001). Patients of 1 group showed higher HDL-C and TG (p<0.05). Probable FH was more common in the patients <45 years (7.34 and 1.32 %, p<0.05), in spite of lower HDL (3.47±0.12 and 3.83±0.08 mmol/l, p<0.05). Conclusions. The most significant risk factors for a MI at a young age are dyslipidemia and increased TG even in the absence of hypercholesterolemia. When allocating the group of familial hypercholesterolemia in patients with myocardial infarction at a yo≤ung age, familial hypercholesterolemia is observed significantly more often. The development of MI at a young age is often accompanied by an increase in the level of fibrinogen, hemoglobin and platelets, which may have a prothrombogenic effect.

scholarly journals Comparison of Management of Depression in Different Age Groups: A Clinical Study

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Anil Kumar Jain ◽  
Sandeep Kumar
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Groups ◽  
Young Patients ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
The Difference

Background: Depression has been considered 4th causes of diseases worldwide according to World Health Organization (WHO). Depression requires proper diagnosis and management in different age groups. This study was conducted to evaluate the comparison of management of depression in different age groups, especially in young, middle and older age groups. Materials & Methods: This study was conducted in department of Psychiatry in year 2010. Those who were diagnosed and obtained treatment in year 2010 were enrolled and considered for the study. It consisted of 240 patients diagnosed with depression. They were divided into 3 groups depending upon age. Group I (Young group) – <40 years, group II (Middle aged group) – 40-60 years and group III (Older group)- >60 years. Each group contained 80 patients each. We evaluated number and type of drugs used for antidepressant treatment, their effectiveness (psychotherapy, pharmacotherapy, combination of psychotherapy and pharmacotherapy, spontaneously remission). Results: This study comprised of 240 patients. They were divided into 3 groups depending upon age. Group I (Young group) – <40 years, group II (Middle aged group)- 40-60 years and group III (Older group)- >60 years. Each group contained 80 patients each. The difference was no significant (P<0.05). 40% of patients in group I, 45% in group II and 65% in group III were of 1 drug only. 20% in group I, 25% in group II and 10% in group III was on 2 drugs. 10% in group I, 15% in group II and 5% in group III was on 3 drugs. Patients were on no drug in group I (30%), group II (15%) and group III (10%). The difference was no significant (P<0.05). 40% of patients were on selective serotonin reuptake inhibitors (SSRI), 25% were on combination of selective serotonin reuptake inhibitors and benzodiazepines (BDZ) and 35% were on benzodiazepines only. In group II, 35% of patients were on selective serotonin reuptake inhibitors (SSRI), 40% were on combination of selective serotonin reuptake inhibitors and benzodiazepines (BDZ) and 25% were on benzodiazepines only. In group III, 40% of patients were on selective serotonin reuptake inhibitors (SSRI), 42% were on combination of selective serotonin reuptake inhibitors and benzodiazepines (BDZ) and 12% were on benzodiazepines only. The difference was significant in all the groups regarding combination therapy and benzodiazepines (P<0.05). Type of therapy used in all groups was either general practitioner (GP) support, psychotherapy, pharmachotherapy, pharmachotherapy or GP support, combination of psychotherapy and pharmachotherapy. There was significant difference in all the groups regarding combination therapy (P<0.01). Conclusion: Young patients usually do not take any medication in depression. Older take more than 1 or 2 medication at same time. Young patients were more on SSRI while older were equally on SSRI and combination of SSRI & BDZ.

Abstract #511: HS CRP in Acute Coronary Syndrome

2016 ◽  
Vol 22 ◽  
pp. 121-122
Author(s):  
Mukhyaprana Prabhu ◽  
Shyny Reddy ◽  
Ranjan Shetty ◽  
V.B. Mohan ◽  
Weena Stanley
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Syndrome ◽  
Hs Crp

Projected future risk of leukemia and brain tumors from unnecessary brain CT scans: a multi-center study in Iran

2020 ◽  
Author(s):  
A. Asgari ◽  
A.A. Parach ◽  
F. Bouzarjomehri ◽  
F. Shirani-Takabi ◽  
A.H. Mehrparvar ◽  
...  
Keyword(s):  
Brain Cancer ◽  
Age Groups ◽  
Young Patients ◽  
Ct Scans ◽  
Brain Ct ◽  
Males And Females ◽  
And Gender ◽  
Multi Center Study ◽  
Gender Groups ◽  
Probability Of Cancer

Introduction: Computer Tomography (CT) scans can deliver a relatively high radiation dose to the patient, therefore radiation protection for this modality is paramount. The present study determined the frequency of no abnormality detected (NAD) brain CT scans and probability of cancer induction in different age groups and genders. Methods: In this study, brain CT reports were used to identify any findings as abnormality detected (AD) and others as NAD. Then probability of future leukemia and brain cancer was estimated for different age and gender groups. Results: On average, in 65% of the cases the results were NAD (56% and 76% among males and females, respectively). Among children, 79% of the reports were NAD. The total number of projected brain cancers was 1.8 and 1.3 for males and females, respectively. The number of projected leukemia cases was 0.75 and 0.7 for males and females, respectively. For pediatric patients, brain CT scans can lead to leukemia cases about 4.5 times more often than adults. Conclusion: Brain CT scans can lead to additional cases of brain cancer and leukemia. A significant fraction of brain CTs were NAD (non-pathologic) and could practically be replaced by other radiation-free imaging modalities, especially in pediatric and young patients.

Relevance of Cardiac Enzymes on Outcome after Urgent CABG for Acute Coronary Syndrome

2016 ◽  
Vol 64 (S 01) ◽  
Author(s):  
I. Slottosch ◽  
O. Liakopoulos ◽  
E. Kuhn ◽  
A. Deppe ◽  
M. Scherner ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Enzymes ◽  
Coronary Syndrome

Reliability of the Mangled Extremity Severity Score in the Management of Peripheral Vascular Injuries in Children: A Retrospective Review

2020 ◽  
Author(s):  
Ahmed Mousa ◽  
Ossama M. Zakaria ◽  
Mai A. Elkalla ◽  
Lotfy A. Abdelsattar ◽  
Hamad Al-Game'a
Keyword(s):  
Severity Score ◽  
Vein Graft ◽  
Bypass Surgery ◽  
Age Groups ◽  
Vascular Injuries ◽  
Peripheral Vascular ◽  
Group Iii ◽  
Mangled Extremity ◽  
Group I ◽  
End To End

AbstractThis study was aimed to evaluate different management modalities for peripheral vascular trauma in children, with the aid of the Mangled Extremity Severity Score (MESS). A single-center retrospective analysis took place between 2010 and 2017 at University Hospitals, having emergencies and critical care centers. Different types of vascular repair were adopted by skillful vascular experts and highly trained pediatric surgeons. Patients were divided into three different age groups. Group I included those children between 5 and 10 years; group II involved pediatrics between 11 and 15 years; while children between 16 and 21 years participated in group III. We recruited 183 children with peripheral vascular injuries. They were 87% males and 13% females, with the mean age of 14.72 ± 04. Arteriorrhaphy was performed in 32%; end-to-end anastomosis and natural vein graft were adopted in 40.5 and 49%, respectively. On the other hand, 10.5% underwent bypass surgery. The age groups I and II are highly susceptible to penetrating trauma (p = 0.001), while patients with an extreme age (i.e., group III) are more susceptible to blunt injury (p = 0.001). The MESS has a significant correlation to both age groups I and II (p = 0.001). Vein patch angioplasty and end-to-end primary repair should be adopted as the main treatment options for the repair of extremity vascular injuries in children. Moreover, other treatment modalities, such as repair with autologous vein graft/bypass surgery, may be adopted whenever possible. They are cost-effective, reliable, and simple techniques with fewer postoperative complication, especially in poor/limited resources.

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