Sex- and Gender-Related Risk Factor Burden in Patients With Premature Acute Coronary Syndrome

Choi, Jin; Daskalopoulou, Stella S.; Thanassoulis, George; Karp, Igor; Pelletier, Roxanne; Behlouli, Hassan; Pilote, Louise

doi:10.1016/j.cjca.2013.07.674

Cited by 60 publications

(40 citation statements)

References 33 publications

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“…Depression was also previously described as a risk factor for ACS. (14,15) These patients can also have atypical etiology, with hereditary thrombophilia and hyperhomocysteinemia being the most frequent etiologies described in previous studies. (9,16) …”

Section: Discussionmentioning

confidence: 84%

Risk factor paradox in the occurrence of cardiac arrest in acute coronary syndrome patients

Rosa¹,

Timóteo²,

Nogueira³

et al. 2016

Revista Brasileira De Terapia Intensiva

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ObjectiveTo compare patients without previously diagnosed cardiovascular risk factors) and patients with one or more risk factors admitted with acute coronary syndrome.MethodsThis was a retrospective analysis of patients admitted with first episode of acute coronary syndrome without previous heart disease, who were included in a national acute coronary syndrome registry. The patients were divided according to the number of risk factors, as follows: 0 risk factor (G0), 1 or 2 risk factors (G1 - 2) and 3 or more risk factors (G ≥ 3). Comparative analysis was performed between the three groups, and independent predictors of cardiac arrest and death were studied.ResultsA total of 5,518 patients were studied, of which 72.2% were male and the mean age was 64 ± 14 years. G0 had a greater incidence of ST-segment elevation myocardial infarction, with the left anterior descending artery being the most frequently involved vessel, and a lower prevalence of multivessel disease. Even though G0 had a lower Killip class (96% in Killip I; p < 0.001) and higher ejection fraction (G0 56 ± 10% versus G1 - 2 and G ≥ 3 53 ± 12%; p = 0.024) on admission, there was a significant higher incidence of cardiac arrest. Multivariate analysis identified the absence of risk factors as an independent predictor of cardiac arrest (OR 2.78; p = 0.019). Hospital mortality was slightly higher in G0, although this difference was not significant. By Cox regression analysis, the number of risk factors was found not to be associated with mortality. Predictors of death at 1 year follow up included age (OR 1.05; p < 0.001), ST-segment elevation myocardial infarction (OR 1.94; p = 0.003) and ejection fraction < 50% (OR 2.34; p < 0.001).ConclusionEven though the group without risk factors was composed of younger patients with fewer comorbidities, better left ventricular function and less extensive coronary disease, the absence of risk factors was an independent predictor of cardiac arrest.

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Section: Discussionmentioning

confidence: 84%

Risk factor paradox in the occurrence of cardiac arrest in acute coronary syndrome patients

Rosa¹,

Timóteo²,

Nogueira³

et al. 2016

Revista Brasileira De Terapia Intensiva

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“…Patients may have already been at target blood pressure and lipid levels at the time of prodromal symptom presentation, however, antiplatelet agents were also not initiated in the majority of patients. Care providers may not recognise the prodromal symptoms given their largely non-specific nature, existing risk scores may underestimate cardiovascular risk in younger patients22 or providers may consider delaying therapy until confirmation of diagnoses.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in prodromal symptoms in acute coronary syndrome in patients aged 55 years or younger

Khan

Daskalopoulou

Karp

et al. 2016

Heart

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“…The prevalence of conventional risk factors like hypertension (67%), dyslipidemia (67%), obesity (53%), smoking (42%), and diabetes (33%) is higher in women with a family history of CAD[33]. …”

Section: Risk Factors Profilementioning

confidence: 99%

Newer perspectives of coronary artery disease in young

Aggarwal

Srivastava

Velmurugan

2016

WJC

108

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Coronary artery disease (CAD) occurring in less than 45 years of age is termed as young CAD. Recent studies show a prevalence of 1.2% of CAD cases in this age group. Ethnic wise south Asians especially Indians are more vulnerable to have CAD in young age group with a prevalence of 5% to 10%. Conventional risk factors such as smoking, diabetes, hypertension, obesity and family history seems to be as important as in older CAD subjects. But the prevalence of these risk factors seems to vary in younger subjects. By far the most commonly associated risk factor is smoking in young CAD. Several genes associated with lipoprotein metabolism are now found to be associated with young CAD like cholesterol ester transfer protein (CETP) gene, hepatic lipase gene, lipoprotein lipase gene, apo A1 gene, apo E gene and apo B. Biomarkers such as lipoprotein (a), fibrinogen, D-dimer, serum Wnt, gamma glutamyl transferase, vitamin D2 and osteocalcin are seems to be associated with premature CAD in some newer studies. In general CAD in young has better prognosis than older subjects. In terms of prognosis two risk factors obesity and current smoking are associated with poorer outcomes. Angiographic studies shows predominance of single vessel disease in young CAD patients. Like CAD in older person primary and secondary prevention plays an important role in prevention of new and further coronary events.

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Sex- and Gender-Related Risk Factor Burden in Patients With Premature Acute Coronary Syndrome

Cited by 60 publications

References 33 publications

Risk factor paradox in the occurrence of cardiac arrest in acute coronary syndrome patients

Risk factor paradox in the occurrence of cardiac arrest in acute coronary syndrome patients

Sex differences in prodromal symptoms in acute coronary syndrome in patients aged 55 years or younger

Newer perspectives of coronary artery disease in young

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