AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 20 Submission ID: 1361 Authors Name & Surname Title Expertise Affiliation Email Country Jaqueline Cindy Govender Dr Medicine UKZN ranjith@lantic.co.za South Africa Naresh Ranjith Prof Cardiology UKZN ranjith@lantic.co.za South Africa Introduction Coronary artery disease [CAD] is a major cause of morbidity and mortality,and although previously reported to be more common in men, is now identified as a leading cause of death and disability in women. Significant differences occur between men and women with respect to the epidemiology, diagnosis, treatment, and prognosis of CAD. In the past, women were often under-represented in many CAD studies, leading to misdiagnosis and inappropriate treatment. There is a paucity of data on the prevalence and mortality outcome of CAD in women from developing countries like South Africa. This study investigated the incidence of acute myocardial infarction [AMI] in women in a regional hospital in Durban, South Africa, with respect to risk profiles and major adverse cardiac events [MACE]. Methods This was a single-center retrospective study conducted at the Coronary Care Unit at RK Khan Hospital, between 2003 to 2016 in female patients with acute myocardial infarction [AMI]. Demographic and clinical data stored in an electronic database were obtained from all patients. Patients with ST elevation MI (STEMI) who were eligible for thrombolysis received Metalyse as a reperfusion therapy. Only patients who consented for both coronary angiography and revascularization were referred to a tertiary hospital due to limited resources. The occurrence of MACE was recorded during hospital admission and 6 months post-discharge. Routine biochemistry was performed on admission using standardized techniques. Results A total of 1311 females were screened of whom 1160 patients were eligible for analyses. The mean age of the study population was 61.6 ± 10.7 years and they were stratified into 2 age groups; < than 65 years [n= 666 (57.4%)] and ≥ 65 years [n= 494 (42.6%)]. The commonest risk factors included dyslipidaemia [97.4%], hypertension [77%], diabetes [75.6%], and a family history of premature atherosclerosis [59%]. When adjusted for age, a significantly greater number of patients < 65 years had dyslipidaemia [P=0.038], obesity [P=<0.001], smoking [P=<0.001], and family history of premature atherosclerosis [ P=<0.001]. In contrast, patients ≥ 65 years were significantly more likely to present with hypertension [ P=<0.001], a previous history of AMI [P=0.004] and angina [P= 0.03]. MACE were observed in 40.2% [n=466] with older patients having a significantly higher prevalence compared to their younger counterparts[46.8% vs 35.3%, P< 0.001 ]. Cardiac failure [54.4%] and death [28.1%] were the most common adverse events seen. Most patients presented with ST elevation MI [74%] with 28% receiving pharmacological reperfusion. Only 337 patients [29%] were subjected to angiographic studies with the majority having triple vessel disease [48.7%], double vessel disease [22.6 %], single vessel disease [22.6%] and normal coronary epicardial vessels [6.2%]. Following multivariable logistic regression analysis, hyperglycaemia [p=0.006], hyperuricaemia [p= 0.001] and hypertriglyceridaemia [p= 0.014] were significantly associated with MACE. Conclusion Our study showed that women presented at a younger age and have multiple risk factors for AMI. A high proportion of patients experienced MACE particularly cardiac failure and death. This highlights the importance of vigilant screening and earlier intervention in women with risk factors that predispose them to CAD. Name: Presenting Author Information Article Category Abstract Title Dr Jaqueline Cindy Govender ranjith@lantic.co.za English Abstract Clinical Risk factor profile of female patients presenting with Acute Myocardial Infarction: A South African perspective Author Affiliation: Email: Prof Naresh Ranjith ORAL PRESENTATION
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