Effect of Age on Clinical Presentation and Outcome of Patients Hospitalized with Acute Coronary Syndrome: A 20-Year Registry in a Middle Eastern Country

Ahmed, Emad; El‐Menyar, Ayman; Singh, Rajvir; Binali, Hajar A Al; Suwaidi, Jassim Al

doi:10.2174/1874192401206010060

Cited by 12 publications

(11 citation statements)

References 25 publications

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“…15 On the other hand, NSTEMI and UA have been reported to be more common in the elderly. 16,17 Similar finding has been observed by another group where majority (70%) of the young patients with ACS presented with STEMI. 18 Mean FBG was relatively high in the case group than that in the control group (p = 0.054).…”

Section: Discussionsupporting

confidence: 86%

Study on Risk Factors and Pattern of Coronary Artery Involvement in Young Acute Coronary Syndrome Patients

Ahmad¹,

Mm²,

Khan³

et al. 2017

Bangladesh Heart J

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Abstract:Aims: To compare the risk factors and pattern of coronary artery involvement in young acute coronary syndrome patients with that of the elderly. Results: Study population was divided into two subgroups, those 18-40 years were considered as young and those >40 years were considered as elderly. Young patients had greater prevalence of smoking, dyslipidemia and positive family history of Ischemic Heart Disease (IHD), whereas hypertension was more prevalent in the elderly. Younger patients mainly presented with STEMI and predominantly had single vessel disease (SVD), whereas elderly patients frequently presented with NSTEMI and Unstable angina and had higher incidence of double vessel disease (DVD) and triple vessel disease (TVD). MethodsConclusion: Younger patients had a different pattern of risk factors and coronary artery involvement in comparision to the elderly.

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Section: Discussionsupporting

confidence: 86%

Study on Risk Factors and Pattern of Coronary Artery Involvement in Young Acute Coronary Syndrome Patients

Ahmad¹,

Mm²,

Khan³

et al. 2017

Bangladesh Heart J

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“…23 On the other hand, NSTEMI and UA have been reported to be more common in the elderly. 24,25 Our present study corroborates these findings.…”

Section: Discussionsupporting

confidence: 92%

Clinico-investigative assessment and comparison of cardiovascular risk factors in young and elderly patients of acute coronary syndrome

et al. 2014

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Background: Coronary artery disease in Indians occurs at an earlier age than most other populations. Risk profile and angiographic severity of young acute coronary syndrome (ACS) patients differ from those in the elderly. Methods: This cross-sectional study included 46 young (≤45 years) and 45 elderly (>45 years) ACS patients. Clinical features, risk factor profiles and coronary angiograms of these patients were studied and compared. Results: Compared with the elderly, more young patients had chest pain and ST-elevated myocardial infarction. Smoking, atherogenic dyslipidemia and abdominal obesity were most frequent in young, while hypertension, high low-density lipoprotein (LDL) cholesterol and abdominal obesity were most prevalent in elderly. High serum homocysteine was the most prevalent novel risk factor in either group. Serum Lp(a) was significantly higher in the young group compared to elderly (p = 0.03). Angiographically, multivessel coronary disease and high Gensini score were more common in elderly. Young group had a low positive correlation between serum triglyceride level and Gensini score (r s = 0.33, p = 0.03). In the elderly, fasting blood glucose and serum triglyceride levels had low positive correlation with Gensini score (r s = 0.36, p = 0.01 and r s = 0.32, p = 0.04 respectively). Conclusions: Cardiovascular risk factors differ in young and elderly ACS patients. Lifestyle changes and behavioral modifications should be emphasized to prevent the development of ACS in the young Indians.

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“…Firstly, it was an in-hospital mortality of STEMI and NSTEMI/UA of both genders and all age groups. As for ACS, many studies had shown higher mortality in women [ 88 , 89 ] and older patients [ 39 , 41 , 90 ]. Hence, the mortality outcome analyzed in this method may have over or underestimated the differences between age groups and across genders.…”

Section: Discussionmentioning

confidence: 99%

Ethnic differences in the occurrence of acute coronary syndrome: results of the Malaysian National Cardiovascular Disease (NCVD) Database Registry (March 2006 - February 2010)

Nordin

2013

BMC Cardiovasc Disord

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BackgroundThe National Cardiovascular Disease (NCVD) Database Registry represents one of the first prospective, multi-center registries to treat and prevent coronary artery disease (CAD) in Malaysia. Since ethnicity is an important consideration in the occurrence of acute coronary syndrome (ACS) globally, therefore, we aimed to identify the role of ethnicity in the occurrence of ACS among high-risk groups in the Malaysian population.MethodsThe NCVD involves more than 15 Ministry of Health (MOH) hospitals nationwide, universities and the National Heart Institute and enrolls patients presenting with ACS [ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA)]. We analyzed ethnic differences across socio-demographic characteristics, hospital medications and invasive therapeutic procedures, treatment of STEMI and in-hospital clinical outcomes.ResultsWe enrolled 13,591 patients. The distribution of the NCVD population was as follows: 49.0% Malays, 22.5% Chinese, 23.1% Indians and 5.3% Others (representing other indigenous groups and non-Malaysian nationals). The mean age (SD) of ACS patients at presentation was 59.1 (12.0) years. More than 70% were males. A higher proportion of patients within each ethnic group had more than two coronary risk factors. Malays had higher body mass index (BMI). Chinese had highest rate of hypertension and hyperlipidemia. Indians had higher rate of diabetes mellitus (DM) and family history of premature CAD. Overall, more patients had STEMI than NSTEMI or UA among all ethnic groups. The use of aspirin was more than 94% among all ethnic groups. Utilization rates for elective and emergency percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) were low among all ethnic groups. In STEMI, fibrinolysis (streptokinase) appeared to be the dominant treatment options (>70%) for all ethnic groups. In-hospital mortality rates for STEMI across ethnicity ranges from 8.1% to 10.1% (p = 0.35). Among NSTEMI/UA patients, the rate of in-hospital mortality ranges from 3.7% to 6.5% and Malays recorded the highest in-hospital mortality rate compared to other ethnic groups (p = 0.000). In binary multiple logistic regression analysis, differences across ethnicity in the age and sex-adjusted ORs for in-hospital mortality among STEMI patients was not significant; for NSTEMI/UA patients, Chinese [OR 0.71 (95% CI 0.55, 0.91)] and Indians [OR 0.57 (95% CI 0.43, 0.76)] showed significantly lower risk of in-hospital mortality compared to Malays (reference group).ConclusionsRisk factor profiles and ACS stratum were significantly different across ethnicity. Despite disparities in risk factors, clinical presentation, medical treatment and invasive management, ethnic differences in the risk of in-hospital mortality was not significant among STEMI patients. However, Chinese and Indians showed significantly lower risk of in-hospital mortality compared to Malays among NSTEMI and UA patients.

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Effect of Age on Clinical Presentation and Outcome of Patients Hospitalized with Acute Coronary Syndrome: A 20-Year Registry in a Middle Eastern Country

Cited by 12 publications

References 25 publications

Study on Risk Factors and Pattern of Coronary Artery Involvement in Young Acute Coronary Syndrome Patients

Study on Risk Factors and Pattern of Coronary Artery Involvement in Young Acute Coronary Syndrome Patients

Clinico-investigative assessment and comparison of cardiovascular risk factors in young and elderly patients of acute coronary syndrome

Ethnic differences in the occurrence of acute coronary syndrome: results of the Malaysian National Cardiovascular Disease (NCVD) Database Registry (March 2006 - February 2010)

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