Metabolic Risk Factors and Outcomes in Acute Coronary Syndrome

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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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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Study of risk factors and its correlation with constraint induced movement therapy for atherosclerosis in patients of coronary artery disease and their offspring

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20200656 ◽

2020 ◽

Vol 7 (3) ◽

pp. 446

Author(s):

Venugopal Margekar ◽

Shweta Thakur ◽

O. P. Jatav ◽

Pankaj Yadav

Keyword(s):

Risk Factors ◽

Family History ◽

Positive Family History ◽

Surrogate Marker ◽

Control Group ◽

Medical College ◽

Constraint Induced Movement Therapy ◽

Group Data ◽

History Of ◽

Artery Disease

Background: A significant percent of cardiovascular event occurs without well-known modifiable risk. A new tool for early identification for atherosclerosis is required for early intervention. Aims and objectives of the study was to study the risk factors for CAD and its correlation with CIMT.Methods: One hundred and forty subjects were studied for the risk factors of CAD in Department of Medicine of G.R. Medical College, Gwalior from 2012 to 2013. Out of 140 subjects, 100 were patients having CAD and 40 age matched subjects were included as control group. Data was also recorded from their offspring. High resolution B mode ultrasonography was performed to assess CIMT of carotid arteries. The maximum CIMT of any one side of carotid artery was taken for study.Results: CAD was more prevalent among males (78%). Majority of the offspring of cases had age between 28-42 years and majority were male (73%). Most common risk factors for CAD was dyslipidemia (48%), hypertension (24%), diabetes (12%) and smoking (21%), whereas in offspring’s of CAD patients, dyslipidemia was seen in 28%, hypertension in 3%, diabetes and tobacco smoking in 12% and 24% respectively. The CIMT of CAD patients was significantly increased with increasing the number of risk factors and the same pattern was also seen in controls. The CIMT of asymptomatic offspring’s having positive family history was significantly more than the asymptomatic offspring without positive family history of CAD.Conclusions: CIMT measurements can be used as a surrogate marker of atherosclerosis as it has showed a direct link with number of risk factors of CAD.

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Peripheral artery disease in outpatients with a recent history of acute coronary syndrome or at high atherothrombotic risk

Vascular ◽

10.1177/1708538120938921 ◽

2020 ◽

pp. 170853812093892 ◽

Cited By ~ 1

Author(s):

Carlos Cantú-Brito ◽

Erwin Chiquete ◽

Javier F Antezana-Castro ◽

Liz Toapanta-Yanchapaxi ◽

Ana Ochoa-Guzmán ◽

...

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Peripheral Artery Disease ◽

Case Fatality ◽

Coronary Risk ◽

Vascular Risk ◽

Peripheral Artery ◽

Coronary Syndrome ◽

History Of ◽

Artery Disease

Objectives The frequency and implications of peripheral artery disease (PAD) in some risk groups are not entirely characterized in Latin America. We studied PAD prevalence, risk factors, and six-month outcomes in stable outpatients with a history of a recent acute coronary syndrome (ACS), or at high coronary risk. Methods We recruited 830 outpatients in 43 Mexican sites (median age: 64.8 years; 57.8% men). Inclusion criteria were age >18 years, and ACS within 30 days, or age <55 years plus ≥2 major vascular risk factors, or age ≥55 years plus ≥1 vascular risk factors. Patients received standardized assessments at baseline and six-month follow-up for medical history, ankle-brachial index (ABI), and the Edinburgh Claudication Questionnaire (ECQ). Results ABI <0.8 was found in 10.5%, <0.9 in 22.5%, >1.3 in 4.8%, and >1.4 in 3.6%, without differences according to sex or selection criteria. Positive ECQ was found in 7.6%. ABI <0.9 was directly associated with age, diabetes, ACS, and chronic kidney disease, but inversely associated with BMI >27. The six-month case-fatality and atherothrombotic events rates were 1.6% and 3.6%, respectively. In patients with ABI <0.9 and ABI <0.8, the six-month case-fatality rates were 2.5% ( p = 0.27) and 5.4% ( p = 0.03), respectively. In a Cox proportional-hazards model, baseline factors associated with death were age ≥65, ABI <0.8, and ACS. Conclusions Subclinical PAD is more common than symptomatic claudication in high-risk coronary outpatients. Low ABI is associated with reduced short-term survival in patients with recent ACS or at high coronary risk.

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Association of Haemoglobin and C-Reactive Protein level with Different Risk Factors among Acute Coronary Syndrome Patients

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v5i2.43022 ◽

2019 ◽

Vol 5 (2) ◽

pp. 156-160

Author(s):

Md Mahboob Morshed ◽

Md Joynul Islam ◽

ATM Ashadullah ◽

Khondker Shaheed Hussain ◽

Mohammad Ahtashamul Haque

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Reactive Protein ◽

Coronary Syndrome ◽

Group 4 ◽

History Of ◽

Study Population ◽

Group 3 ◽

Group 2 ◽

Group 1

Background: Different risk factors may be related with the haemoglobin and CRP level among the acute coronary syndrome patients. Objective: The purpose of the present study was to see the association of haemoglobin and CRP level with different type of risk factors among the acute coronary syndrome patients. Methodology: This cross-sectional study was conducted in the Department of Cardiology at Mymensingh Medical College, Mymensingh, Bangladesh from December 2010 to November 2011 for a period of two (02) years. Patients of ACS who were presented within 12 hours of chest pain were included as study population. Study population were categorized in four groups according to the level of hemoglobin and C-reactive protein. Age, cardiovascular risks factor, history, family history of cardiovascular disease, treatment history and ECG were taken during admission. Blood sample was collected for baseline laboratory investigations like Troponin-I, Random Blood Sugar (RBS), Blood urea, Serum creatinine, lipid profile, Hemoglobin & CRP level. Sample were then send to standard laboratory/Biochemistry department of MMCH. Result: The mean age of the population was 52.18±8.88 years. Smoking was the highest percentage in Group 1 which was 54(50.0%) cases (P=0.001). Hypertension was found most common in group 1 (47.6%), Group 2 (33.3%), Group 3 (10.7%) and Group 4 (8.3%). Smoking (p=0.001) and hypertension (p=0.016) was found statistically significant. Diabetes was found in Group 1 (37.7%), Group 2 (43.5%), Group 3 (11.6%) and Group 4 (7.2%). Group 1 (50%) and Group 2 (50%) patients were dyslipidaemic. Family history of IHD was present group-1 (36.8%), Group 2 (44.7%), Group 3 (73.2%) and Group 4 (53%). Among the smoker patient 65.6% cases had CRP level ˃12 mg/l; 39.8% cases had CRP level ˂12mg/L. Among the nonsmoker 34.4% cases had CRP level ˃12mg/l and 60.2% cases had CRP level ˂12mg/L. The finding was statistically significant. Conclusion: In conclusion haemoglobin and CRP level is associated with different type of risk factors among the acute coronary syndrome patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 156-160

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Fragmented QRS Complex as a Predictor of Multivessel Disease in Acute Coronary Syndrome

Indonesian Journal of Cardiology ◽

10.30701/ijc.v37i3.576 ◽

2017 ◽

pp. 130-6

Author(s):

Idar Mappangara ◽

Abdul Hakim Alkatiri ◽

Stefan Hendyanto

Keyword(s):

Acute Coronary Syndrome ◽

Logistic Regression ◽

Cross Sectional Study ◽

Multivessel Disease ◽

P Value ◽

Qrs Complex ◽

Cross Sectional ◽

Coronary Syndrome ◽

Fragmented Qrs ◽

History Of

Background: The incidence of multivessel disease in acute coronary syndrome (ACS) is expected to be identified as early as possible in order to perform optimal management. The presence of multivessel disease can lead to ischemia or myocardial infarction. Fragmented QRS complex (fQRS) is a new electrocardiography (ECG) parameter that has been proven to be caused by ischemia or myocardial infarction.Methods: A cross-sectional study. Patients with ACS that admitted at Dr. Wahidin Sudirohusodo Makassar since December 2014 - March 2015 who are eligible were enrolled in this study.Presence of fQRS evaluated on first 12-lead ECG at hospital admission. Presence of multivessel disease based on coronary angiography. Data were analyzed by logistic regression. Data was significant if the p-value<0.05.Results: There are 63 subjects (56 men and 7 women) included in this study. Older age, history of ACS before, presence of dyslipidemia, and presence of fQRS were significantly more often in group with multivessel disease. After analyzed with logistic regression, the fQRS was the only significant predictor of multivessel disease with p value 0.003 and odds ratio 13.28.Conclusion: Presence of fQRS in the first 12-lead ECG when admitted to the hospital was an independent predictor of multivessel disease in patients with ACS.

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Prevalence of Psoriasis Vulgaris and Its Associated Risk Factors in Pakistan

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i43b32585 ◽

2021 ◽

pp. 390-395

Author(s):

Syeda Ujala Sohail ◽

Nasima Iqbal ◽

Ashok Kumar ◽

Sarwath Fatimee ◽

Ayesha Khan ◽

...

Keyword(s):

Risk Factors ◽

Standard Deviation ◽

Family History ◽

Psoriasis Vulgaris ◽

Age Of Onset ◽

Strong Association ◽

Positive Family History ◽

P Value ◽

History Of ◽

Associated Risk Factors

Aim: To find out the prevalence of psoriasis vulgaris and its associated risk factors. Study Design: Descriptive cross-sectional. Place and Duration of Study: Study was conducted at Rawalpindi Leprosy Hospital during January 2019 to December 2019. Methodology: The diagnosed cases of Psoriasis Vulgaris (PsV) were included in the study. All the patients were investigated on the basis of an in depth Performa. The Performa include all the relevant clinical and family history of the patient along with the personal details. Data was analyzed by using Statistical Package for the Social Sciences (SPSS) version 20. All the numerical variables were presented as mean with standard deviation while categorical data as frequency and percentages. The association of risk factors with the Psoriasis was calculated by using the Chi-square test. p-value less than 0.05 was considered as significant. Results: Mean age with standard deviation of patients was 34.7±14. Most of the diagnosed patients were male and below 40 years of age, only 4.2% cases were having positive family history of Psoriasis and found significant correlation. The frequency of onset of symptoms in adolescent was more as compared to childhood i.e. 95.3% and 4.7% respectively. Majority of psoriasis cases (65.3%) were from non-smoker group and having strong association with smoking. The frequency of arthritis among psoriasis patients was 23.7% and majority of the patients, who developed arthritis were those having age <40 year and were suffering from psoriasis since 5-10 years. Conclusion: Current study concluded that Psoriasis vulgar is having higher prevalence rate among male and below 40 years of age group. The results also suggested a strong association of severity of psoriasis with certain risk factors including family history, age of onset of symptoms, smoking and arthritis.

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ACUTE MYOCARDIAL INFARCTION;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.06.2625 ◽

2014 ◽

Vol 21 (06) ◽

pp. 1200-1203

Author(s):

Shahzad Alam Khan ◽

Sohail Safdar ◽

Asna Ijaz ◽

Ijaz-Ul-Haque Taseer

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Family History ◽

Positive Family History ◽

Descriptive Study ◽

Research Centre ◽

Female Ratio ◽

First Degree Relatives ◽

History Of

Objective: To determine the frequency of family history of IHD and related risk factors in the first degree relatives of patients suffered from acute myocardial infarction (AMI). Study Design: Descriptive study. Setting: PMRC Research Centre, Nishtar Medical College, Multan, Cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology, Multan. Duration: One year from July 2011 to June 2012. Material and methods: In this descriptive study 331 patients of AMI of either sex and age ≥ 20 years admitted in Cardiology unit of Nishtar Hospital Multan and Chaudhary Pervez Elahi Institute of Cardiology Multan were registered. For data collection non-probability convenient sampling technique was used. Informed consent was taken from each patient. The information were recorded in a pre-designed questionnaire. The data were analyzed through SPSS-11. Results: Mean age of the study cases was 54.99±11.25 years (Minimum age was 20 years and maximum was 90 years). Two hundred sixty four (79.8%) were male and 67 (20.2%) were female patients and male to female ratio was 3.9:1. Out of these 331 patients 111 (33.6 %) were having positive family history of IHD. In these 111 (33.6 %) cases history of diabetes was seen in 45 (40.5 %), 43(38.8 %) had history of hypertension and history of hyper-cholesterolemia was present in 23 (20.7 %) of cases. Conclusions: The family history of IHD in addition to traditional risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking is itself an important risk factor for IHD. Relatives of the young patients with IHD should be considered as high risk group and it calls for close surveillance of their first degree relatives and early intervention. All their family members should be advised life style modification, appropriate management of risk factors and regular follow up of even apparently healthy descendents.

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Epidemiology and risk factors of patients with types of acute coronary syndrome presenting to a tertiary care hospital in Sri Lanka

BMC Cardiovascular Disorders ◽

10.1186/s12872-019-1217-x ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Udaya Ralapanawa ◽

Pallegoda Vithanage Ranjith Kumarasiri ◽

Kushalee Poornima Jayawickreme ◽

Prabashini Kumarihamy ◽

Yapa Wijeratne ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Sri Lanka ◽

Unstable Angina ◽

Stable Angina ◽

Strong Association ◽

Coronary Syndrome ◽

History Of ◽

St Elevation

Abstract Background Acute Coronary Syndrome (ACS) is one of the leading causes of death worldwide and studies have shown higher mortality rates and premature death in South Asian countries. The occurrence and effect of risk factors differ by type ofACS.Epidemiological studies in the Sri Lankan population are limited. Methods This is a cross sectional descriptive study conducted at the Teaching Hospital Peradeniya, Sri Lanka among patients presenting with ACS. Data was collected by an interviewer administered structured questionnaire and epidemiological patterns and risk factors were analyzed. Results The sample of 300 patients had a mean age of 61.3+/− 12.6 and male sex showed higher association with all three type of ACS compared to female with a P value of 0.001. This study showed higher mean age of 62.2 ± 11.4 years amongst unstable angina (UA) patients and 61.9 ± 14.5 years amongst non ST elevation myocardial infarction (NSTEMI) patients compared to 59.2 ± 11.2 years for ST elevation myocardial infarction (STEMI) patients with no significant statistical difference (P = 0.246). Approximately 55.8% STEMI patients, 39.8% UA and 35.5% NSTEMI patients were smokers indicating a significant association between smoking and STEMI (P = 0.017). Nearly 54.5% STEMI, 35.4% UA and 32.7% NSTEMI patients consumed alcohol and there was a very strong association between alcohol consumption and STEMI (P = 0.006). Almost 51.8% NSTEMI patients, 47.8% UA patients and 29.9% STEMI patients had hypertension(HT) (P = 0.008) indicating significant association of HT with UA and NSTEMI. About 33.6% UA patients and 30.0% NSTEMI patients had DM whilst only 22.1% of STEMI patients had DM of no significance (p = 0.225). Around 15.0% patients with UA, 25.5% with NSTEMI and 11.7% with STEMI had dyslipidemia (P = 0.032). There was a very strong association between a past history of ACS or stable angina with NSTEMI and UA (P = 0.001). Conclusion Smoking and alcohol abuse are significantly associated with STEMI.Patients with NSTEMI or Unstable Angina had higher rates of hypertension and were more likely to have a history of ACS or stable angina than STEMI patients. Patients with NSTEMI were more likely than patients with STEMI or UA to have dyslipidemia.

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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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Distribution of Risk Factors in Patients with Acute Coronary Syndrome – a Hospital Based Study

Journal of Nepal Medical Association ◽

10.31729/jnma.636 ◽

2003 ◽

Vol 42 (148) ◽

Author(s):

Man B KC ◽

S Rajbhandari ◽

D Sharma ◽

R Malla ◽

YR Limbu ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Disease Risk ◽

Positive Family History ◽

Modifiable Risk Factors ◽

Coronary Syndrome ◽

Strong Trend ◽

Artery Disease

A total of 230 patients admitted in coronary care unit of Shahid Gangalal National Heart Centre in betweenNovember 2001 and October 2002 were studied. 157 (68.2%) were male, with mean age of 62.8±11.8 years.Majority of acute coronary syndrome (ACS) events were observed in males with advanced age (> 65 years).About 68% patients with ACS were smoker, the most common modifiable risk factor followed by hypertension,dyslipidaemia and diabetes. A strong trend towards development of coronary artery disease (CAD) wasfound in subjects with positive family history of CAD. Multiple risk factors (2 or more) were present in vastmajority of patients. Modifiable risk factors, with smoking at number one position are more common inacute coronary syndrome patients. Appropriate management of modifiable risk factors is advisable to reducethe incidence of coronary artery disease.Key Words: Coronary Artery Disease, Risk Factors.

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