Key result
NSTEMI comprises ~49% of first ACS presentations in young Indian women, frequently involving single-vessel disease.
Why the study?
Despite the pronounced incidence of cardiovascular disease in women, evidence-based studies investigating the characteristics of ACS in Indian women are lacking.
Observational (n=179)
No
In young Indian women (<55 years) presenting with their first episode of ACS, dyslipidemia and diabetes are highly prevalent, and NSTEMI with single-vessel disease is the most common presentation.
NSTEMI with single-vessel disease predominates in young Indian women with first ACS; leaves open whether region-specific risk profiles warrant tailored prevention.
Background: Despite the fact that the incidence of cardiovascular disease is more pronounced in women, there is a lack of evidence-based studies that investigate the characteristics of acute coronary syndrome (ACS) in Indian women. Aim: The study aimed to assess the clinical characteristics, angiographic profile, and hospital outcomes of ACS in women <55 years of age in a tertiary care hospital of Northern Kerala. Materials and Methods: This was an observational study. In total, 179 women with <55 years of age, who had experienced the first episode of ACS were included in the study. Baseline characteristics including demography, risk factor, clinical presentation, and therapeutic management were reported. Results: Out of 179 female patients, 102 (57%) patients were postmenopausal. The most common risk factors of ACS in our population were found to be dyslipidemia (64.80%), followed by diabetes mellitus (58.10%) and hypertension (41.34%). The most frequent clinical presentation of ACS was non-ST-elevation myocardial infarction (STEMI) (49.16%), followed by STEMI (26.26%) and unstable angina (24.58%). Regarding the severity of disease, single-vessel disease (32%) was more common, followed by double-vessel disease (28%) and triple-vessel disease (24%). Left anterior descending artery (116 patients) was the most frequently involved artery in female patients, followed by right coronary artery (72 patients). Postprocedure complications associated with the study were as follows: hematoma (two patients), pseudoaneurysm (one patient), and takotsubo cardiomyopathy (one patient). Deaths were reported in two patients. Conclusions: The epidemiological trend of ACS, especially in the postmenopausal women, has been continuously rising in developing countries including India. Hence, more emphasis should be given on the identification of risk factors, clinical presentation, and diagnosis in this vulnerable group, which is ultimately beneficial for therapeutic management as well as reduces mortality and morbidity.
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Manzil et al. (2020) conducted an observational in Acute Coronary Syndrome (n=179). Among 179 Indian women under 55 with a first episode of ACS, NSTEMI was the most common presentation (49.16%), and single-vessel disease was the most frequent angiographic finding (32%).
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