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

Ge, Junhua; Li, Jian; Yu, Hua; Hou, Bo

doi:10.1155/2018/7623639

Cited by 28 publications

(22 citation statements)

References 35 publications

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“…However, comparative data relating to subclinical characteristics in young ACS patients is still limited; some previous studies have shown different results, possibly due to differences in sample selection and anthropometry characteristics of research subjects. [ 16 , 18 , 19 ]…”

Section: Discussionmentioning

confidence: 99%

Age related differences in acute coronary syndrome: An observation at a central hospital in Vietnam

Anh

Minh

et al. 2021

Journal of Translational Internal Medicine

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Background and Objectives There is little data regarding the characteristics of young Vietnamese patients (<40 years old) who get acute coronary syndrome (ACS). This study aimed to compare the risk factors, clinical-subclinical characteristics, coronary lesions, and mortality prediction (based on the GRACE and TIMI scores) of young ACS patients with their older counterparts. Methods A cross-sectional descriptive study was conducted amongst 69 patients with ACS at the Cardiovascular Center of Hue Central Hospital from May 2017 to December 2018. These patients were divided into two groups: 33 patients were < 40 years old (group 1), and 36 patients were ≥ 40 years old (group 2). Demographic data, risk factors profile, clinical-subclinical characteristics, coronary lesions, and mortality prediction were compared between the two groups. Results Compared with group 2, group 1 had a higher proportion of severe angina (the prevalence of angina graded III-IV by CCS classification was 69.7% in group 1 versus 36.1% in group 2, P = 0.0108) and lower systolic pressure (median was 120 mmHg in group 1 versus 135 mmHg in group 2, P = 0.006). The prevalence of unstable angina and STEMI was higher in group 1 (51.5% and 36.4% in group 1 versus 30.6% and 11.1% in group 2, respectively), while NSTEMI was higher in group 2 (58.3% in group 2 versus 12.1% in group 1, P = 0.0002). The prevalence of single-vessel CAD, normal coronary angiography (CAG), nonobstructive CAD in group 1 was also higher and multi-vessel CAD was lower than group 2 (45.5%, 33.3%, 12.1% and 9.1% in group 1 versus 33.3%, 2.8%, 2.8% and 61.2% in group 2, respectively). The Gensini, GRACE, and TIMI scores were lower in group 1 (median was 5; medium was 78.55 and median was 2 in group 1 versus 37.5, 130.22 and 3 in group 2, respectively). Smoking was a risk factor for obstructive CAD in group 1 (OR = 7.12, 95% CI: 1.25–40.63, P < 0.05). Conclusion Young patients with ACS tended to be males, smokers, and with positive familial history; the grade of angina was more severe, and systolic pressure was lower; the prevalence of unstable angina and STEMI was higher. Smoking was a risk factor for obstructive CAD in young patients.

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Section: Discussionmentioning

confidence: 99%

Age related differences in acute coronary syndrome: An observation at a central hospital in Vietnam

Anh

Minh

et al. 2021

Journal of Translational Internal Medicine

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“…As regarding to admission diagnosis, 21% of our patients diagnosed as Non 128.6 ± 19.4 and the mean HR was 72.0 ± 14.4, this may be due to small sample size of our study [18].…”

Section: Discussionmentioning

confidence: 73%

Prevalence of Cardiovascular Risk Factors and Heterozygous Familial Hypercholesterolemia in Premature Atherosclerotic Patients Presenting with Acute Coronary Syndrome

Reda¹,

Soliman²,

Elkersh³

et al. 2021

WJCD

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Background: Heterozygous familial hypercholesterolemia is an autosomal dominant genetic disorder with an estimated prevalence of 1/200-1/500 in the general population. Early identification of patient with familial hypercholesterolemia is important, because appropriate treatment may reduce the risk of premature atherosclerosis. Objective: Assessment of the prevalence of different modifiable cardiovascular risk factors and clinical diagnosis of heterozygous familial hypercholesterolemia. Methods: One hundred patients were enrolled, included young patients (males less than 50 years and females less than 60 years old) presented with first attack of acute coronary syndrome either ST elevation myocardial infarction (STEMI), non ST elevation myocardial infarction (NSTEMI) or unstable angina (UA). All patients were subjected to full history taking, general and local examination, Electrocardiogram, transthoracic Echocardiography, laboratory investigations, coronary angiography and Dutch score calculation for familial hyperlipidemias. Results: The mean level of serum cholesterol among studied group was 268.31 ± 59.33, HDL-C was 39.63 ± 7.52, LDL was 192.27 ± 60.61 and TG was 180.10 ± 39.64. With application of Dutch score, 20% of patients diagnosed definite familial hypercholesterolemia with Dutch score > 8. Twenty-six percent of patients diagnosed as probable familial hypercholesterolemia with Dutch score 6-8. Thirty-nine percent patients diagnosed as possible familial hypercholesterolemia with Dutch score 3-5 and 15% of patients were unlikely familial hypercholesterolemia with Dutch score < 3 with significant correlation between Dutch score and age, total cholesterol, LDL-C, serum creatinine. Conclusion: Familial hypercholesterolemia (FH) is one of the most common serious genetic disorders of cholesterol metabolism.

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“…Hypertension appeared to be the most prominent modifiable risk factor (54.71%) in our study and is consistent with the other studies. A study done in India by Mohanan et al(2013) 18 reported 48.8% hypertension in ACS patients while in another study done recently in China by Ge et al (2018) 19 have documented 57.2% patients of ACS with hypertension. Our study reported that both history of previous IHD and family history (37.65%) were same among all patient and these findings are almost in agreement with those of Ralapanawa et al (2019) 20 who carried out research on 300 ACS patients and investigated that previous history of IHD in patients and family history of IHD were 41% and 33% respectively.…”

Section: Resultsmentioning

confidence: 96%

Clinical and electrocardiographic profile of patients presenting with acute coronary syndrome in emergency department in a Tertiary Care Hospital.

Mahmood¹,

Khawaja²,

Iqbal³

et al. 2020

TPMJ

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Objectives: To assess the clinical characteristics and diagnosis of ACS for timely, management and further prevention from coronary events. Study Design: Cross sectional study. Setting: Emergency Department (ED) of Punjab Institute of Cardiology (PIC) Lahore. Period: November 2017 to January 2018. Material & Methods: Included 170 diagnosed patients of ACS of both sexes presenting within approximately four hours of symptoms. At presentation ECG and initial blood samples were taken from all patients for base line and Troponin T estimation. All the patients included in the study were properly examined and complete history was taken. Blood samples of patients for diagnosis of NSTEMI were also drawn at 8hrs of arrival. The patients were categorized into STEMI, NSTEMI and UA on the basis of history, ECG and cardiac Troponin T. Results were analyzed statistically. A p-value ≤ 0.05 was considered statistically significant. Results: A total of 170 patients with established diagnosis of ACS were included. The mean age of the patients was 56 years. There was a very strong male predominance (81.76%). The major modifiable risk factors were hypertension (54.71%) and smoking (35.88%), followed by hyperlipidemia (35.29%) and diabetes (32.35%). A previous history of IHD in patients and family history of IHD were equally present (37.65%). A large proportion of patients belonged to middle class (54.12%) and lower (41.18%). Typical pain chest pain was present in 90% and majority of patients enrolled in this study had a diagnosis of myocardial infarction 77.05% and the remainder had unstable angina. We found a higher percentage of ST elevation MI in the patients with MI (84.73%), majority had anterior AMI. Of all patients, 1.77% expired during hospital stay. Conclusion: The majority of ACS patients in our country are male with STEMI. The major risk factors are hypertension, family history of IHD, smoking, hyperlipidemia and diabetes. 90% patients present with typical chest pain while remaining 10% atypical symptoms which must be of prime consideration to assess ACS.

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

Cited by 28 publications

References 35 publications

Age related differences in acute coronary syndrome: An observation at a central hospital in Vietnam

Age related differences in acute coronary syndrome: An observation at a central hospital in Vietnam

Prevalence of Cardiovascular Risk Factors and Heterozygous Familial Hypercholesterolemia in Premature Atherosclerotic Patients Presenting with Acute Coronary Syndrome

Clinical and electrocardiographic profile of patients presenting with acute coronary syndrome in emergency department in a Tertiary Care Hospital.

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