Treatment and outcomes of acute coronary syndromes in India (CREATE): a prospective analysis of registry data

Xavier, Denis; Пайс, Прем; Devereaux, P. J.; Xie, Changchun; Prabhakaran, Dorairaj; Reddy, K. Srinath; Gupta, Rajeev; Joshi, Prashant; Kerkar, Prafulla; Thanikachalam, Sadagopan; Haridas, Kaushik; Jaison, T M; Naik, Sudhir; Ak, Maity; Yusuf, Salim

doi:10.1016/s0140-6736(08)60623-6

Cited by 553 publications

(616 citation statements)

References 21 publications

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“…Baseline demographic characteristics, past medical history, clinical presentation, medical therapy, cardiac procedures and clinical outcomes were compared between the three age groups ( 50, 51e70, and >70 years). 10 Statistical analyses were conducted using one-way ANOVA test for continuous variables and Pearson chi-square (X 2 ) test for categorical variables. The clinical hospital outcomes included recurrent ischemia, myocardial reinfarction, heart failure (HF), shock, stroke, major bleedings and mortality.…”

Section: Discussionmentioning

confidence: 99%

Age and clinical outcomes in patients presenting with acute coronary syndromes

Ahmed

AlHabib

El‐Menyar

et al. 2013

Journal of Cardiovascular Disease Research

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a b s t r a c tContext: Elderly patients have more cardiovascular risk factors and a greater burden of ischemic disease than younger patients. Aims: To examine the impact of age on clinical presentation and outcomes in patients presenting with acute coronary syndrome (ACS). Methods and material: Collected data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2), which is a prospective multicenter study from six adjacent Arab Middle Eastern Gulf countries. Patients were divided into 3 groups according to their age: 50 years, 51e70 years and >70 years and their clinical characteristics and outcomes were analyzed. Mortality was assessed at one and 12 months. Statistical analysis used: One-way ANOVA test for continuous variables, Pearson chi-square (X 2 ) test for categorical variables and multivariate logistic regression analysis for predictors were performed. Results: Among 7930 consecutive ACS patients; 2755 (35%) were 50 years, 4110 (52%) were 51e70 years and 1065 (13%) >70 years old. The proportion of women increased with increasing age (13% among patients 50 years to 31% among patients > 70 years). The risk factor pattern varied with age; younger patients were more often obese, smokers and had a positive family history of CAD, whereas older patients more likely to have diabetes mellitus, hypertension, and dyslipidemia. Advancing age was associated with under-treatment evidence-based therapies. Multivariate logistic regression analysis after adjusting for relevant covariates showed that old age was independent predictors for re-ischemia (OR 1.29; 95% CI 1.03e1.60), heart failure (OR 2.8; 95% CI 2.17e3.52) and major bleeding (OR 4.02; 95% CI 1.37 e11.77) and in-hospital mortality (age 51e70: OR 2.67; 95% CI 1.86e3.85, and age >70: OR 4.71; 95% CI 3.11e7.14). Conclusion: Despite being higher risk group, elderly are less likely to receive evidence-based therapies and had worse outcomes. Guidelines adherence is highly recommended in elderly.

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Section: Discussionmentioning

confidence: 99%

Age and clinical outcomes in patients presenting with acute coronary syndromes

Ahmed

AlHabib

El‐Menyar

et al. 2013

Journal of Cardiovascular Disease Research

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“…Levels of smoking and drinking are the highest amongst the lowest income quintile in India. 70 This leads to the early onset of cardiac diseases amongst this segment of the population. They tend to ignore the disease due to poor access to healthcare, high cost of treatment, social stigma, and low awareness.…”

Section: Rural Urban Trend Of Cardiovascular Diseasesmentioning

confidence: 99%

Cardiovascular disease risk factors in Asian Indian population: A systematic review

Nag

Ghosh

2014

Journal of Cardiovascular Disease Research

118

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a b s t r a c tBackground: Cardiovascular diseases (CVDs) are the number one cause of death globally and are the leading cause of death in India also. Several surveys conducted across the country over the past few decades have shown a rising prevalence of major risk factors for CVD in Asian Indian population. The problem of increasing risk factors for CVD in India is because of lack of surveillance system and lack of proper diagnosis. This study will help to point out the need of research so that some advanced diagnosis system may be developed for proper diagnosis of CVDs and to reduce the growing burden of CVDs in the country. Methods: We did a literature search for the period from 1968 to 2012 using PUBMED search to identify all relevant studies of cardiovascular diseases. Besides PUBMED searching, manual searching has also been done. This article provides a review of current understanding of the epidemiology of cardiovascular disease, particularly, coronary heart disease (CHD), stroke and related risk factors in Asian Indian population. Results: Hypertension and diabetes are highly prevalent among Asian Indian population, which may explain their high rate of stroke and heart attack in India. The increasing rate of CVD may be explained by the high rates of other risk factors including adverse lipid profile. The etiology of cardiovascular diseases (CVD) is multifactorial and no single factor is an absolute cause. Conclusion: The cardiovascular diseases and its risk factors are increasing with a rapid pace in Asian Indian population. Though the prevalence of CVD risk factors is found higher in urban population, yet it is increasing at an alarming rate in rural population also, which is a serious threatening to the nation. Since majority of the Indians live in rural area, CVD may lead to epidemic proportions. We need health promotion programs and reorientation of primary health care to improve CVD detection in earlier stage and its management.

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“…Unlike other studies, we found that older age 13,18 or female gender 16,19 are not independent predictors for CIN, this may be due to the under representation of these subgroups in this study (age >70 years À13% and female gender e 16.4%). This is not uncommon in the Indian context where elderly or females receive fewer coronary interventions 20 and those who do receive usually belong to the higher economic strata and hence may represent lower risk peer group. Other established risk factors like peripheral vascular disease, 21,22 albuminuria, 23,24 anemia, 13,25 hypotension, 13,18 renal impairment 17,22 and high contrast volume 13,26 form the rest of the components of this risk scoring system.…”

Section: Discussionmentioning

confidence: 99%