Clinical profile and 30-day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease: A single-center observational study
Background: Gender disparity, with respect to women receiving less medical therapy, undergoing fewer invasive procedures, and experiencing worse outcome than men, has been noted in various observational and randomized trials, though guidelines on acute coronary syndrome (ACS) are gender-neutral. Ind...
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| Format: | Article |
| Language: | English |
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Elsevier
2016-03-01
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| Series: | Indian Heart Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483215003491 |
| _version_ | 1819283520833454080 |
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| author | Veena Nanjappa Gopi Aniyathodiyil R. Keshava |
| author_facet | Veena Nanjappa Gopi Aniyathodiyil R. Keshava |
| author_sort | Veena Nanjappa |
| collection | DOAJ |
| description | Background: Gender disparity, with respect to women receiving less medical therapy, undergoing fewer invasive procedures, and experiencing worse outcome than men, has been noted in various observational and randomized trials, though guidelines on acute coronary syndrome (ACS) are gender-neutral. Indian data with focus on women with ACS are lacking.
Aim: This study was undertaken to give us an insight on the clinical presentation, risk factors, and in-hospital outcome of ACS in women and at 30 days.
Materials and methods: 133 successive cases of women presenting with ACS, who met the inclusion criteria between 2012 and 2014, were included. Cases were grouped into ST elevation myocardial infarction (STEMI), non ST elevation myocardial infarction (NSTEMI), and unstable angina (UA).
Results and conclusion: The mean age was 64.4 ± 11 years. The mean BMI was 23.64 ± 3.23 kg/m2. Diabetes was present in 58.3% in NSTEMI, 65.1% in STEMI, and 57.1% in UA group. Hypertension was found in 75% of NSTEMI, 60.2% of STEMI, and 71.4% of UA group. Severe MR was found in 11.1% of NSTEMI and 3.6% of STEMI patients. 8.3% of NSTEMI and 15.7% of STEMI patients presented in Killips class IV. Single vessel disease was most commonly found across the spectrum of ACS. 68.7% patients in STEMI group underwent primary angioplasty. 5.6% of NSTEMI and 7.2% in STEMI group had contrast-induced nephropathy (CIN). All deaths were noted in STEMI group with eight in-hospital deaths and three during 30-day follow-up period. Killips class III and IV and higher grace score (>150) were predictors of in-hospital mortality. Chronic kidney disease, ischemic mitral regurgitation, LV clot, and in-hospital cardiac arrest were associated with higher risk. |
| first_indexed | 2024-12-24T01:32:48Z |
| format | Article |
| id | doaj.art-29a8c3ce19db4c14b72ec07ed16f5fdd |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-24T01:32:48Z |
| publishDate | 2016-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-29a8c3ce19db4c14b72ec07ed16f5fdd2022-12-21T17:22:17ZengElsevierIndian Heart Journal0019-48322016-03-0168216416810.1016/j.ihj.2015.08.006Clinical profile and 30-day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease: A single-center observational studyVeena Nanjappa0Gopi Aniyathodiyil1R. Keshava2Cardiology Registrar, Fortis Hospital, Cunningham Road, Bangalore, Karnataka, IndiaInterventional Cardiologist, Fortis Hospital, Cunningham Road, Bangalore, Karnataka, IndiaInterventional Cardiologist, Fortis Hospital, Cunningham Road, Bangalore, Karnataka, IndiaBackground: Gender disparity, with respect to women receiving less medical therapy, undergoing fewer invasive procedures, and experiencing worse outcome than men, has been noted in various observational and randomized trials, though guidelines on acute coronary syndrome (ACS) are gender-neutral. Indian data with focus on women with ACS are lacking. Aim: This study was undertaken to give us an insight on the clinical presentation, risk factors, and in-hospital outcome of ACS in women and at 30 days. Materials and methods: 133 successive cases of women presenting with ACS, who met the inclusion criteria between 2012 and 2014, were included. Cases were grouped into ST elevation myocardial infarction (STEMI), non ST elevation myocardial infarction (NSTEMI), and unstable angina (UA). Results and conclusion: The mean age was 64.4 ± 11 years. The mean BMI was 23.64 ± 3.23 kg/m2. Diabetes was present in 58.3% in NSTEMI, 65.1% in STEMI, and 57.1% in UA group. Hypertension was found in 75% of NSTEMI, 60.2% of STEMI, and 71.4% of UA group. Severe MR was found in 11.1% of NSTEMI and 3.6% of STEMI patients. 8.3% of NSTEMI and 15.7% of STEMI patients presented in Killips class IV. Single vessel disease was most commonly found across the spectrum of ACS. 68.7% patients in STEMI group underwent primary angioplasty. 5.6% of NSTEMI and 7.2% in STEMI group had contrast-induced nephropathy (CIN). All deaths were noted in STEMI group with eight in-hospital deaths and three during 30-day follow-up period. Killips class III and IV and higher grace score (>150) were predictors of in-hospital mortality. Chronic kidney disease, ischemic mitral regurgitation, LV clot, and in-hospital cardiac arrest were associated with higher risk.http://www.sciencedirect.com/science/article/pii/S0019483215003491Acute coronary syndrome in womenRisk factorsIn-hospital outcome30-day follow-upTertiary hospital data |
| spellingShingle | Veena Nanjappa Gopi Aniyathodiyil R. Keshava Clinical profile and 30-day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease: A single-center observational study Indian Heart Journal Acute coronary syndrome in women Risk factors In-hospital outcome 30-day follow-up Tertiary hospital data |
| title | Clinical profile and 30-day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease: A single-center observational study |
| title_full | Clinical profile and 30-day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease: A single-center observational study |
| title_fullStr | Clinical profile and 30-day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease: A single-center observational study |
| title_full_unstemmed | Clinical profile and 30-day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease: A single-center observational study |
| title_short | Clinical profile and 30-day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease: A single-center observational study |
| title_sort | clinical profile and 30 day outcome of women with acute coronary syndrome as a first manifestation of ischemic heart disease a single center observational study |
| topic | Acute coronary syndrome in women Risk factors In-hospital outcome 30-day follow-up Tertiary hospital data |
| url | http://www.sciencedirect.com/science/article/pii/S0019483215003491 |
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