Influence of sex on the profile of acute coronary syndrome: a tertiary care hospital based study from the Sub-Himalayan region in North India

Abstract

INTRODUCTIONCardiovascular Disease has so far accounted for nearly half of all deaths in the developed world and 25 percent of deaths in the developing countries. By 2020 it has been projected that there will be an increase by almost 75 percent in the global CVD. 1 CVD has assumed epidemic proportions in India. These epidemics are driven by socioeconomic changes that have profound effects on life style. Urbanization, Industrialization and especially globalization propelled developing countries into the worldwide epidemic of CVD. There is a strong positive correlation in the increase in CHD in India with risk factors like diabetes, hypertension, dyslipidemia, metabolic syndrome, smoking and sedentary lifestyle. The conventional risk factors can be modifiable and nonmodifiable. Age and gender are non modifiable risk factors for coronary artery disease. Heart diseases are far more age dependent in women than in men. ABSTRACTBackground: Coronary events presents about ten years later in women than men. There exist distinct gender differences in terms of presentation of symptoms, validity of diagnostic tests and complications. Methods: The study was conducted in the department of medicine R.P. Govt. Medical College (RPGMC) Himachal Pradesh. Consecutive 300 patients of acute coronary syndrome from June 2011 to June 2012 were included in the study. Demographical profile was recorded with focused clinical examination and relevant investigation with lipid profile was done. Results: Among the study population of 300 individuals, 201 (67%) were males and 99 (33%) were females. The mean age among male patients was 61.3±11.7 years and in female patients the mean age was 65.6±11.20 years. 68.8% of females presented after 60 yrs of age. Dyslipidemia was the commonest risk factor followed by hypertension and obesity. 12.2% of female patients were smokers. Chest pain was the commonest presenting symptom seen in 82% cases. There was mean delay of 31.0±54.5 hrs in the presentation of females for treatment. ST Elevated Myocardial Infarction occurred less frequently in females. Conclusions: Acute coronary syndrome is more age dependent in females. The predominance of dyslipidemia, hypertension and obesity as risk factors gives a message for primary care physicians to create awareness for the prevention of Acute Coronary Syndrome. The atypical symptoms should be recognised early which should further prevent the delay in presentation.

Common Comorbidities Among Stroke Patient and Their Outcome in a Tertiary Care Hospital, Bangladesh

“…This result correlates with the study done by Badiuzzaman M et al 13 Regarding the types of stroke, ischemic stroke accounts for about 2/3 rd of total cases worldwide. In this study, 61.40% of patients had ischemic stroke, 34.31% had ICH, and 4.79% had SAH.This variation in our study due to the clinical presentations of ICH compelled them to get admit into the hospital .This result is similar to the study done by Khan M M Z et al 14 in Bangladesh and a study done by Kapoor D et al 15 in North India.…”