Acute Coronary Syndrome in Young Adults from a Malaysian Tertiary Care Centre

Hoo, Fan Kee; Foo, Yoke Loong; Lim, Sazlyna Mohd Sazlly; Ching, Siew Mooi; Boo, Yang Liang

doi:10.12669/pjms.324.9689

Cited by 21 publications

(19 citation statements)

References 14 publications

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“…Previous studies showed that the prevalence of ACS among population less than 45 years of age (young ACS) ranged from 2% to 10% [ 4 – 6 ]. Young ACS cases were more prevalent among the Malays (49.8%), followed by Indians (24.4%), Chinese (21.8%), and other races (4.1%) [ 2 ]. Risk factors of ACS are age-dependent.…”

Section: Introductionmentioning

confidence: 99%

“…Jamil et al reported that prevalence of smoking (79.2% vs. 66.2%, p<0.001) was significantly higher, while prevalence of diabetes (12.1% vs. 25.6%, p<0.001), hypertension (34.4% vs. 57.4%, p<0.001), and hyperlipidemia (39.7% vs. 50.1%, p<0.001) was significantly lower in young ACS patients compared to elderly (>55 years old) ACS patients [ 7 ]. Smoking was identified as one of the major risk factors of ACS in young adults [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Hypertension Is an Independent Predictor of Multivessel Coronary Artery Disease in Young Adults with Acute Coronary Syndrome

et al. 2018

International Journal of Hypertension

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Background Risk factors of multivessel coronary artery disease (CAD) among young acute coronary syndrome (ACS) patients remain elusive now. Methods This retrospective study analyzed data from 187 consecutive young (age ≤45 years) ACS patients (75 STEMI, 30 NSTEMI, and 72 unstable angina) hospitalized in our hospital from January 2012 to December 2016. Thirty-six young male patients with normal coronary angiography (CAG) findings (no-CAD), who underwent CAG due to suspected chest pain in this period, served as control group. There were 83 patients with single-vessel disease (SVD) and 104 patients with multiple-vessel disease (MVD) among ACS patients. Patients were followed up for a mean of 267±124 days by clinical visit or telephone calls. Results All included patients were male. Prevalence of hypertension (57.2% vs. 30.6%, p=0.002) and smoking (70.6% vs. 52.8%, p=0.049) was significantly higher in ACS patients than in no-CAD patients. Prevalence of hypertension (72.1% vs. 38.6%, p<0.001) and body mass index (BMI) were significantly higher in MVD group than in SVD group. Multivariable analysis revealed that hypertension was an independent risk factor for MVD after adjustment for age, gender, BMI, smoking, family history of premature CAD, hyperlipidemia, left ventricular ejection fraction, and brain natriuretic peptide (odds ratio=3.71, 95% confidence interval=1.84-7.46, p<0.001). Rate of major adverse cardiovascular events (MACE) during follow-up (20.2% vs. 4.8%) was significantly higher in MVD group compared with SVD group. Conclusions Hypertension is an independent predictor of MVD and MVD is associated with increased MACE rate compared to SVD in young ACS patients during the short-term follow-up.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hypertension Is an Independent Predictor of Multivessel Coronary Artery Disease in Young Adults with Acute Coronary Syndrome

et al. 2018

International Journal of Hypertension

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“…23 The male preponderance was expected, with established evidence highlighting ischaemia as being more prevalent in males and postmenopausal women. 24 With regards to ethnic distribution, there is also evidence supporting a high proportion of ischaemia amongst Malays and Indians, as seen in both local (Zuhdi et al 25 and Hoo et al 26 ) and regional studies (Wong et al 27 ). Furthermore, studies have previously reported a higher prevalence of obesity and poor rate of engagement in physical activity amongst those of Malay and Indian descent.…”

Section: Discussionmentioning

confidence: 95%

Cross-Sectional Study of Ethnicity and Chronic Heart Failure: Complex Interplay of Health and Wealth

Abidin¹,

Shariff²,

Kasim³

2020

EMJ

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Objectives: Extrapolating data from international and regional registries on chronic heart failure provides a challenge in Malaysia in view of it being a multicultural country. This study aimed to illustrate the chronic heart failure landscape within northern Kuala Lumpur and identify differences amongst major ethnic groups. Methods: A retrospective, single-centre study was conducted between the 1st January 2013 and 30th April 2016. Patients with left ventricular ejection fraction ≤45% were identified and information was collected on these individuals’ demographics, risk factors, and aetiology. Comparisons were made between three major ethnic groups within Malaysia, and between the author’s database and that of other international registries. Results: 1,181 patients were identified, the majority being Malays (67.3%) and male (81.2%). The mean age was 58.2±11.7 years. The majority had ischaemic risk factors, including previous and current smoking habits (56.7%), coronary artery disease (66.1%), hypertension (71.2%), diabetes (61.8%), and dyslipidaemia (47.9%). There were significant differences noted when looking at rates of dyslipidaemia, diabetes, atrial fibrillation, and chronic kidney disease amongst different ethnicities. The mean left ventricular ejection fraction in Malays was lower (33.1±9.6%) compared to that of Chinese (34.7±8.7%) and Indians (34.9±8.3%). There was marked differences seen in this study’s cohort, compared to three major Asian registries: The 2003 Chong et al. registry, Inter-CHF, and ASIAN-HF. Conclusion: There exists great disparity in chronic heart failure burden amongst populations, and therefore local registries are needed to narrow the gap in knowledge regarding chronic heart failure within Malaysia.

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“…Worryingly, there is a rapid emergence of increasing trend among younger Malaysians to present with CAD. Hoo et al reported that 6.1% of patients with Acute Coronary Syndrome (ACS) were less than 45 years of age with the mean age of young ACS in their study was 39 ± 6 years 4 . The trend is consistent with other nearby South East Asian countries 5 .…”

Section: Introductionmentioning

confidence: 90%

Identification of Coronary Risk Factors Among Urban and Rural Malaysian Youths and Their Possible Underlying Causes

Nor

Chua

Razak

et al. 2021

Preprint

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Background: Coronary artery disease (CAD) is one of the major causes of morbidity and mortality worldwide. Early identification of the coronary risk factors (CRF) among youths assists in determining the high-risk group to develop CAD in later life. In view of the modernised lifestyle, both urban and rural residing youths are thought to be equally exposed to various CRF. This study aimed to describe the common CRF including obesity, dyslipidaemia, hypertension, smoking and family history of premature CAD in Malaysian youths residing in urban and rural areas. Methods: We recruited 942 Malaysian subjects aged 15–24 years old [(males=257, and urban=555 vs rural=387, (mean age + SD = 20.5 + 2.1 years)] from the community health screening programmes organised in both rural and urban regions throughout Malaysia. Medical history and standardised anthropometric measurements were recorded. Laboratory investigations were obtained for fasting serum lipid profiles and plasma glucose levels. Results: Youths in the rural were more overweight and obese (49.4% vs 42.7%, p<0.044) and have higher family history of hyperlipidaemia (16.3% vs 11.3%, p<0.036) than youths in the urban areas. Low-density lipoprotein (LDL-c) (2.8 vs 2.7 mmol/L) and total cholesterol (TC) (4.7 vs 4.5 mmol/L) were significantly higher in urban compared to rural youths (p<0.019 and p<0.012). Overall, more youth in this study has CRF rather than not (Has CRF = 67.0% vs No CRF = 33.0%). Significantly more rural youths have at least one CRF compared to urban youths (rural = 71.6% vs urban = 63.8%, p=0.012). Conclusion: In conclusion, rural youths have significantly higher BMI with higher family history of hyperlipidaemia compared to urban youths. However, urban youths have higher LDL-c and TC levels. Other coronary risk factors are not significantly different between urban and rural youths. CRF were significantly more prevalent among rural compared to urban youths.

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Acute Coronary Syndrome in Young Adults from a Malaysian Tertiary Care Centre

Cited by 21 publications

References 14 publications

Hypertension Is an Independent Predictor of Multivessel Coronary Artery Disease in Young Adults with Acute Coronary Syndrome

Hypertension Is an Independent Predictor of Multivessel Coronary Artery Disease in Young Adults with Acute Coronary Syndrome

Cross-Sectional Study of Ethnicity and Chronic Heart Failure: Complex Interplay of Health and Wealth

Identification of Coronary Risk Factors Among Urban and Rural Malaysian Youths and Their Possible Underlying Causes

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