دورية أكاديمية
أعرض في EDS

Presentation, management, and early outcomes of young acute coronary syndrome patients- analysis of 23,560 South Asian patients from 2012 to 2021.

التفاصيل البيبلوغرافية
العنوان: Presentation, management, and early outcomes of young acute coronary syndrome patients- analysis of 23,560 South Asian patients from 2012 to 2021.
المؤلفون: Peerwani G; Department of Clinical Research Cardiology, Tabba Heart Institute, Karachi, Pakistan., Hanif B; Department of Cardiology, Tabba Heart Institute, Karachi, Pakistan., Rahim KA; Dean's Office, Medical College, Aga Khan University, Karachi, Pakistan.; Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan., Kashif M; Department of Clinical Research Cardiology, Tabba Heart Institute, Karachi, Pakistan., Virani SS; Department of Medicine, Aga Khan University, Karachi, Pakistan.; Office of the Vice Provost, Research, Aga Khan University, Karachi, Pakistan., Sheikh S; Department of Clinical Research Cardiology, Tabba Heart Institute, Karachi, Pakistan. sana.sheikh@aku.edu.
المصدر: BMC cardiovascular disorders [BMC Cardiovasc Disord] 2024 Jul 19; Vol. 24 (1), pp. 378. Date of Electronic Publication: 2024 Jul 19.
نوع المنشور: Journal Article; Comparative Study
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968539 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2261 (Electronic) Linking ISSN: 14712261 NLM ISO Abbreviation: BMC Cardiovasc Disord Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Acute Coronary Syndrome*/therapy , Acute Coronary Syndrome*/mortality , Acute Coronary Syndrome*/ethnology , Acute Coronary Syndrome*/diagnosis , Hospital Mortality* , Registries*, Humans ; Female ; Male ; Middle Aged ; Time Factors ; Age Factors ; Adult ; Risk Factors ; Risk Assessment ; Pakistan/ethnology ; Treatment Outcome ; Aged ; Prevalence ; Asian People
مستخلص: Background: There is dearth of literature addressing early outcomes of acute coronary syndrome (ACS) among young patients, particularly South Asians descent who are predisposed to premature coronary artery disease (CAD). Therefore, we compared presentation, management, and early outcomes of young vs. old ACS patients and explored predictors of in-hospital mortality.
Methods: We extracted data of 23,560 ACS patients who presented at Tabba Heart Institute, Karachi, Pakistan, from July 2012-June 2020, from the Chest pain-MI-Registry™. We categorized data into young ≤ 45 and old ACS patients > 45 years. Chi-sq/Fischer exact tests were used to assess the difference between presentation, disease management, and in-hospital mortality between both groups. Logistic regression was used to determine odds ratio along with 95% confidence interval of factors associated with early mortality.
Results: The younger patients were 12.2% and women 23.5%. The prevalence of dyslipidemia (34.5% vs. 22.4%), diabetes (52.1% vs. 27.4%), and hypertension (68.3% vs. 42.9%) was higher in older patients. Family history of premature CAD (18.1% vs. 32.7%), smoking (40.0% vs. 22.9%), and smokeless tobacco use (6.5% vs. 8.4%) were lower in older patients compared to younger ones. Younger patients were more likely to present with STEMI (33.2% vs. 45%). The median symptom-to-door time was 125 min longer (p-value < 0.01) in the young patients compared to the older age group. In-hospital mortality (4.3% vs. 1.7%), cardiac arrest (1.9% vs. 0.7%), cardiogenic shock (1.9% vs. 0.9%), and heart failure (1% vs. 0.6%) were more common in older patients. After adjusting for other factors, younger age (AOR 0.6, 95% CI 1.5-3.7) had significantly lesser odds of in-hospital mortality. Other factors associated with early mortality included women, family history of premature CAD, STEMI, Killip class III and IV, coronary angiography, revascularization, CABG, and use of aspirin and beta blockers within the first 24 h.
Conclusion: We found every tenth ACS patient was younger than 45 years of age despite a lesser number of comorbidities such as hypertension and diabetes. Overall, the in-hospital prognosis of young patients was more favorable than that of older patients. The study emphasizes the need for tailored primary prevention programs for ACS, considering the varying risks among different age groups.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Acute coronary syndrome; In-hospital mortality; Low-middle-income country; Pakistan; Young
تواريخ الأحداث: Date Created: 20240719 Date Completed: 20240719 Latest Revision: 20240725
رمز التحديث: 20240726
مُعرف محوري في PubMed: PMC11264989
DOI: 10.1186/s12872-024-04036-1
PMID: 39030502
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2261
DOI:10.1186/s12872-024-04036-1