Acute coronary syndrome in the young Nepalese population with their angiographic characteristics

Abstract

Background & Objectives: Acute cor onar y syndr ome (ACS) is an emerging cardiac problem in the young population in Asia and Nepalese population is not an exception to this. Early ACS in young age imparts huge familial and social economic burden. Early identification and proper management strategy is still a challenging problem in developing countries like Nepal where there are limited coronary intervention centers. The study was conducted with objective to study the clinical spectrum, etiologies, coronary angiographic characteristics and their clinical outcomes. Materials & Methods: This is a cross-sectional study carried out in a tertiary hospital in central Nepal. Forty patients with acute coronary syndrome with age less than 40 years were enrolled in the study. Results: Majority of the patients were males with male: female=1.8:1. Twenty six (65%) patients were having ST segment elevation myocardial infarction followed by non-ST elevation myocardial infarction in nine (22.50%) patients and unstable angina in five (12.50%). patients. The most common risk factors were smoking, systemic hypertension, diabetes mellitus and dyslipidemia. Majority were having single vessel disease. Twenty (50%) patients had undergone primary angioplasty followed by thrombolysis in seven patients and the rest were managed medically because of late presentation. In-hospital major adverse cardiac events and mortality were higher among STEMI than NSTEMI and unstable angina. Conclusion: Acute coronary syndrome in the young is increasing in the Nepalese population. This group of population should be well educated and made aware of the potential coronary risk factors and their modification.

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

“…Our study showed 12.9% pa ents with age less than 45 years which is slightly higher than other parts of 10 world but regarding Nepal, study done by Laudari S 11 showed 11.11% in pa ents with age less than 40 years. There is increasing trend of ACS in young as noted from 10,11 same clinical se ng in different frame of me too. Not only young males, young females have also been seen presen ng with rising trends of ACS in this study.…”

“…The prevalence of ACS among popula on less than 45 years of age (considered as young ACS) is 2 to 10% in studies [2][3][4][5][6][7][8][9] conducted from different parts of world. There are few studies in Nepal regarding ACS in young with a prevalence of [10][11] 8.8-11%. Our study showed 12.9% pa ents with age less than 45 years which is slightly higher than other parts of 10 world but regarding Nepal, study done by Laudari S 11 showed 11.11% in pa ents with age less than 40 years.…”

“…There are few studies in Nepal regarding ACS in young with a prevalence of [10][11] 8.8-11%. Our study showed 12.9% pa ents with age less than 45 years which is slightly higher than other parts of 10 world but regarding Nepal, study done by Laudari S 11 showed 11.11% in pa ents with age less than 40 years. There is increasing trend of ACS in young as noted from 10,11 same clinical se ng in different frame of me too.…”

“…The prevalence of ACS among popula on less than 45 years of old (considered as young ACS) is 2 to 10% in studies conducted from different parts of [2][3][4][5][6][7][8][9] world. There are few studies in Nepal regarding ACS in [10][11] young with a prevalence of 8.8-11%.…”

“…Cardiovascular risk factors, such as smoking, dyslipidemia, obesity, and family history of coronary artery disease (CAD), have been seen as more frequent among young ACS in [2][3][4][5][6][7][8][9][10][11] these studies. Not only this, there are different theories behind the exact pathophysiology of ACS as different other e ologies and novel risk factors like homocysteinemia may be implicated than older popula on.…”