Pattern of risk factors and management strategies in patients with acute coronary syndrome

Abstract

Objective The aim of the study was to assess the pattern of risk factors of acute coronary syndrome (ACS) in patients with coronary artery disease (CAD) in different age groups and sex categories. Background ACS refers to a spectrum of clinical presentations ranging from those for ST-segment elevation myocardial infarction to presentations found in non-ST-segment elevation myocardial infarction or in unstable angina. Patient and methods This is a prospective, observational, noncontrolled study including 200 patients with ACS who were admitted at As-Salam International Hospital from August 2015 to March 2016. The patients were classified into four groups according to age: patients younger than 45 years, patients between 45 and 55 years, patients between 55 and 64 years, and patients aged 65 years or older. Further, a comparison was made between male and female patients. Results There was a significant difference between the studied groups as regards the prevalence of diabetes mellitus (DM), hypertension (HTN), and cigarette smoking, with no significant difference as regards positive family history of premature CAD. There was significant difference between male and female patients as regards the prevalence of DM, HTN, and cigarette smoking, with no significant difference as regards positive family history of premature CAD, dyslipidemia, and lipid profile. Conclusion The youngest patients had a higher incidence of smoking, were mostly male, had a positive family history of premature CAD, a low BMI, and had a poor lipid profile compared with other groups. In contrast, they had a lower incidence of other risk factors as diabetes, HTN, and low high-density lipoprotein values. The oldest patients (group 4) had the lowest incidence of some risk factor as DM, HTN, smoking, total cholesterol (TCh), low low-density lipoprotein levels, waist circumference, and BMI, which gave rise to the suspicion that age alone is an important risk factor for CAD. Female patients had a higher incidence of HTN, dyslipidemia, high levels of BMI, and atherogenic lipid profile compared with male patients. In contrast, they had a lower incidence of DM, positive family history of premature CAD, and smoking.