Vikas Agrawal1, Balaji V Lohiya2, Bhupendra K Sihag2, Rajpal Prajapati2. 1. Assistant Professor, Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University , Varanasi, Uttar Pradesh, India . 2. Senior Resident, Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University , Varanasi, Uttar Pradesh, India .
Abstract
INTRODUCTION: Despite cardiovascular diseases having grown to epidemic proportions, there are few studies from India pertaining to Acute Coronary Syndrome (ACS), more so from the region of Purvanchal which is less developed with more poverty. Our study is first of its kind in this region of patients presenting for the first time with ACS. AIM: The present study was undertaken to study the clinical and angiographic characteristics of ACS patients of Purvanchal. MATERIALS AND METHODS: This was a prospective cohort study of 100 patients admitted with ACS. Patients were excluded if they had prior cardiac pathology like valvular heart disease, cardiomyopathy, pericardial disease, cor pulmonale, ischaemic heart disease or cardiac revascularisation. Patients who did not undergo angiography were excluded. Patients were divided into ST Elevation Myocardial Infarction (STEMI) and non STEMI (NSTEMI). Presentation delays as well as clinical characteristics analysed in each group were age, gender, presence or absence of diabetes mellitus, hypertension, dyslipidaemia, smoking, Body Mass Index (BMI), family history, duration of chest pain, and treatment received. RESULTS: Mean age of patients was 58.9 years with 27% below 50 years. Of the total 75% were males. Patients with STEMI were 65%. Median time to reach hospital was 24 hours with only 27% patients reaching hospital within 6 hours. Among patients with STEMI only 43% received fibrinolytic therapy. 23% patients had diabetes, 21% were hypertensive, 16% were smokers, family history of cardiovascular disease present in 11% and 21% had body mass index more than 30. Mean LDL was 115mg/dl and HDL 39mg/dl with 54% of patients having at least one risk factor. Factors favouring triple vessel involvement were female sex, higher age, smoking, presence of diabetes and NSTEMI. CONCLUSION: Indians develop ACS at earlier age. Precious time is lost before seeking treatment. There is a need for aggressive risk factor modification which along with health awareness will be the key to prevent premature cases of ACS and limit morbidity and mortality due to delayed treatment.
INTRODUCTION: Despite cardiovascular diseases having grown to epidemic proportions, there are few studies from India pertaining to Acute Coronary Syndrome (ACS), more so from the region of Purvanchal which is less developed with more poverty. Our study is first of its kind in this region of patients presenting for the first time with ACS. AIM: The present study was undertaken to study the clinical and angiographic characteristics of ACS patients of Purvanchal. MATERIALS AND METHODS: This was a prospective cohort study of 100 patients admitted with ACS. Patients were excluded if they had prior cardiac pathology like valvular heart disease, cardiomyopathy, pericardial disease, cor pulmonale, ischaemic heart disease or cardiac revascularisation. Patients who did not undergo angiography were excluded. Patients were divided into ST Elevation Myocardial Infarction (STEMI) and non STEMI (NSTEMI). Presentation delays as well as clinical characteristics analysed in each group were age, gender, presence or absence of diabetes mellitus, hypertension, dyslipidaemia, smoking, Body Mass Index (BMI), family history, duration of chest pain, and treatment received. RESULTS: Mean age of patients was 58.9 years with 27% below 50 years. Of the total 75% were males. Patients with STEMI were 65%. Median time to reach hospital was 24 hours with only 27% patients reaching hospital within 6 hours. Among patients with STEMI only 43% received fibrinolytic therapy. 23% patients had diabetes, 21% were hypertensive, 16% were smokers, family history of cardiovascular disease present in 11% and 21% had body mass index more than 30. Mean LDL was 115mg/dl and HDL 39mg/dl with 54% of patients having at least one risk factor. Factors favouring triple vessel involvement were female sex, higher age, smoking, presence of diabetes and NSTEMI. CONCLUSION: Indians develop ACS at earlier age. Precious time is lost before seeking treatment. There is a need for aggressive risk factor modification which along with health awareness will be the key to prevent premature cases of ACS and limit morbidity and mortality due to delayed treatment.
Entities:
Keywords:
Coronary angiography; Non ST elevation MI; ST elevation MI
Authors: D Hasdai; S Behar; L Wallentin; N Danchin; A K Gitt; E Boersma; P M Fioretti; M L Simoons; A Battler Journal: Eur Heart J Date: 2002-08 Impact factor: 29.983
Authors: Kristian Thygesen; Joseph S Alpert; Allan S Jaffe; Maarten L Simoons; Bernard R Chaitman; Harvey D White; Kristian Thygesen; Joseph S Alpert; Harvey D White; Allan S Jaffe; Hugo A Katus; Fred S Apple; Bertil Lindahl; David A Morrow; Bernard R Chaitman; Peter M Clemmensen; Per Johanson; Hanoch Hod; Richard Underwood; Jeroen J Bax; Jeroen J Bonow; Fausto Pinto; Raymond J Gibbons; Keith A Fox; Dan Atar; L Kristin Newby; Marcello Galvani; Christian W Hamm; Barry F Uretsky; Ph Gabriel Steg; William Wijns; Jean-Pierre Bassand; Phillippe Menasche; Jan Ravkilde; E Magnus Ohman; Elliott M Antman; Lars C Wallentin; Paul W Armstrong; Maarten L Simoons; James L Januzzi; Markku S Nieminen; Mihai Gheorghiade; Gerasimos Filippatos; Russell V Luepker; Stephen P Fortmann; Wayne D Rosamond; Dan Levy; David Wood; Sidney C Smith; Dayi Hu; Jose-Luis Lopez-Sendon; Rose Marie Robertson; Douglas Weaver; Michal Tendera; Alfred A Bove; Alexander N Parkhomenko; Elena J Vasilieva; Shanti Mendis; Jeroen J Bax; Helmut Baumgartner; Claudio Ceconi; Veronica Dean; Christi Deaton; Robert Fagard; Christian Funck-Brentano; David Hasdai; Arno Hoes; Paulus Kirchhof; Juhani Knuuti; Philippe Kolh; Theresa McDonagh; Cyril Moulin; Bogdan A Popescu; Zeljko Reiner; Udo Sechtem; Per Anton Sirnes; Michal Tendera; Adam Torbicki; Alec Vahanian; Stephan Windecker; Joao Morais; Carlos Aguiar; Wael Almahmeed; David O Arnar; Fabio Barili; Kenneth D Bloch; Ann F Bolger; Hans Erik Botker; Biykem Bozkurt; Raffaele Bugiardini; Christopher Cannon; James de Lemos; Franz R Eberli; Edgardo Escobar; Mark Hlatky; Stefan James; Karl B Kern; David J Moliterno; Christian Mueller; Aleksandar N Neskovic; Burkert Mathias Pieske; Steven P Schulman; Robert F Storey; Kathryn A Taubert; Pascal Vranckx; Daniel R Wagner Journal: J Am Coll Cardiol Date: 2012-09-05 Impact factor: 24.094
Authors: C P Cannon; W S Weintraub; L A Demopoulos; R Vicari; M J Frey; N Lakkis; F J Neumann; D H Robertson; P T DeLucca; P M DiBattiste; C M Gibson; E Braunwald Journal: N Engl J Med Date: 2001-06-21 Impact factor: 91.245
Authors: Lori Mandelzweig; Alex Battler; Valentina Boyko; Hector Bueno; Nicolas Danchin; Gerasimos Filippatos; Anselm Gitt; David Hasdai; Yonathan Hasin; Jaume Marrugat; Frans Van de Werf; Lars Wallentin; Shlomo Behar Journal: Eur Heart J Date: 2006-08-14 Impact factor: 29.983
Authors: Philippe Gabriel Steg; Robert J Goldberg; Joel M Gore; Keith A A Fox; Kim A Eagle; Marcus D Flather; Immad Sadiq; Rachel Kasper; Sophie K Rushton-Mellor; Frederick A Anderson Journal: Am J Cardiol Date: 2002-08-15 Impact factor: 2.778
Authors: Jang Hoon Lee; Hun Sik Park; Shung Chull Chae; Yongkeun Cho; Dong Heon Yang; Myung Ho Jeong; Young Jo Kim; Kee-Sik Kim; Seung Ho Hur; In Whan Seong; Taek Jong Hong; Myeong Chan Cho; Chong Jin Kim; Jae Eun Jun; Wee Hyun Park Journal: Am J Cardiol Date: 2009-07-15 Impact factor: 2.778
Authors: K J Raihanathul Misiriya; N Sudhayakumar; S Abdul Khadar; Raju George; V L Jayaprakasht; Joseph M Pappachan Journal: J Assoc Physicians India Date: 2009-05
Authors: Denis Xavier; Prem Pais; P J Devereaux; Changchun Xie; D Prabhakaran; K Srinath Reddy; Rajeev Gupta; Prashant Joshi; Prafulla Kerkar; S Thanikachalam; K K Haridas; T M Jaison; Sudhir Naik; A K Maity; Salim Yusuf Journal: Lancet Date: 2008-04-26 Impact factor: 79.321
Authors: Santanu Guha; Rishi Sethi; Saumitra Ray; Vinay K Bahl; S Shanmugasundaram; Prafula Kerkar; Sivasubramanian Ramakrishnan; Rakesh Yadav; Gaurav Chaudhary; Aditya Kapoor; Ajay Mahajan; Ajay Kumar Sinha; Ajit Mullasari; Akshyaya Pradhan; Amal Kumar Banerjee; B P Singh; J Balachander; Brian Pinto; C N Manjunath; Chandrashekhar Makhale; Debabrata Roy; Dhiman Kahali; Geevar Zachariah; G S Wander; H C Kalita; H K Chopra; A Jabir; JagMohan Tharakan; Justin Paul; K Venogopal; K B Baksi; Kajal Ganguly; Kewal C Goswami; M Somasundaram; M K Chhetri; M S Hiremath; M S Ravi; Mrinal Kanti Das; N N Khanna; P B Jayagopal; P K Asokan; P K Deb; P P Mohanan; Praveen Chandra; Col R Girish; O Rabindra Nath; Rakesh Gupta; C Raghu; Sameer Dani; Sandeep Bansal; Sanjay Tyagi; Satyanarayan Routray; Satyendra Tewari; Sarat Chandra; Shishu Shankar Mishra; Sibananda Datta; S S Chaterjee; Soumitra Kumar; Soura Mookerjee; Suma M Victor; Sundeep Mishra; Thomas Alexander; Umesh Chandra Samal; Vijay Trehan Journal: Indian Heart J Date: 2017-03-23