Jayesh Prajapati1, Hasit Joshi2, Sibasis Sahoo3, Kapil Virpariya3, Meena Parmar4, Komal Shah5. 1. Professor and Head, Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre , Ahmedabad, India . 2. Associate Professor, Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre , Ahmedabad,India . 3. Assistant Professor, Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre , Ahmedabad, India . 4. Clinical Cardiologist, Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre , Ahmedabad, India . 5. Research Officer, Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre , Ahmedabad, India .
Abstract
CONTEXT: Although numerous risk factors have been established to predict the development of acute coronary syndrome (ACS), the risk factor profile may be different between the younger and older individuals. AIM: To analyse the frequency and pattern of atherogenic risk factors and angiographic profiles in age-stratified Gujarati patients with ACS. MATERIALS AND METHODS: ACS patients undergoing coronary angiography at U.N. Mehta Institute of Cardiology and Research, Gujarat, India between January 2008 and December 2012 were classified in to two age groups with 40y as cut-off. Patients were assessed for conventional risk factors (diabetes mellitus, dyslipidaemia, hypertension, smoking, obesity), novel risk factors (high sensitivity C-reactive protein, lipoprotein (a), homocysteine), and angiographic profiles.The statistical difference between two age groups was determined by Student's t-test for continuous variables and Chi-square or Fisher's exact test for categorical variables. RESULTS: A total of 200 patients, 100 patients ≤40 y of age and 100 patients >40 y of age, were evaluated. Older patients had higher frequency of hypertension (32 vs. 16%, p=0.008), while family history of coronary artery disease was more common among younger patients (19 vs. 9%, p=0.041). The incidence of diabetes, dyslipidaemia, smoking and tobacco chewing did not vary significantly between the two groups. Total cholesterol and low-density lipoprotein cholesterol levels were significantly higher in the younger group (p<0.05). Lipoprotein (a), homocysteine and high-sensitivity C reactive protein levels were comparable between two age groups. Multi-vessel coronary artery disease was more common among older group. The most commonly affected coronary artery was the left anterior descending artery among younger patients (44%) and the left circumflex artery among older patients (38.1%). CONCLUSION: Young patients with ACS had different atherosclerotic risk profile and less extensive coronary artery disease as compared to older counterparts. Emphasis should be given on diagnosis and management of major modifiable risk factors.
CONTEXT: Although numerous risk factors have been established to predict the development of acute coronary syndrome (ACS), the risk factor profile may be different between the younger and older individuals. AIM: To analyse the frequency and pattern of atherogenic risk factors and angiographic profiles in age-stratified Gujarati patients with ACS. MATERIALS AND METHODS: ACS patients undergoing coronary angiography at U.N. Mehta Institute of Cardiology and Research, Gujarat, India between January 2008 and December 2012 were classified in to two age groups with 40y as cut-off. Patients were assessed for conventional risk factors (diabetes mellitus, dyslipidaemia, hypertension, smoking, obesity), novel risk factors (high sensitivity C-reactive protein, lipoprotein (a), homocysteine), and angiographic profiles.The statistical difference between two age groups was determined by Student's t-test for continuous variables and Chi-square or Fisher's exact test for categorical variables. RESULTS: A total of 200 patients, 100 patients ≤40 y of age and 100 patients >40 y of age, were evaluated. Older patients had higher frequency of hypertension (32 vs. 16%, p=0.008), while family history of coronary artery disease was more common among younger patients (19 vs. 9%, p=0.041). The incidence of diabetes, dyslipidaemia, smoking and tobacco chewing did not vary significantly between the two groups. Total cholesterol and low-density lipoprotein cholesterol levels were significantly higher in the younger group (p<0.05). Lipoprotein (a), homocysteine and high-sensitivity C reactive protein levels were comparable between two age groups. Multi-vessel coronary artery disease was more common among older group. The most commonly affected coronary artery was the left anterior descending artery among younger patients (44%) and the left circumflex artery among older patients (38.1%). CONCLUSION: Young patients with ACS had different atherosclerotic risk profile and less extensive coronary artery disease as compared to older counterparts. Emphasis should be given on diagnosis and management of major modifiable risk factors.
Authors: Børge G Nordestgaard; M John Chapman; Kausik Ray; Jan Borén; Felicita Andreotti; Gerald F Watts; Henry Ginsberg; Pierre Amarenco; Alberico Catapano; Olivier S Descamps; Edward Fisher; Petri T Kovanen; Jan Albert Kuivenhoven; Philippe Lesnik; Luis Masana; Zeljko Reiner; Marja-Riitta Taskinen; Lale Tokgözoglu; Anne Tybjærg-Hansen Journal: Eur Heart J Date: 2010-10-21 Impact factor: 29.983
Authors: Omar Sami Obeidat; Hanna Makhamreh; Ra'ad Zaid Al-Muhaisen; Layan R Obeidat; Farah I Kitana; Justin Z Amarin; Mahmoud Ahmed Ebada; Mhd Anas Murad; Tuqa Alhameedi; Dania Haj-Yasin; Ayman Hammoudeh Journal: Heart Views Date: 2021-08-19