학술논문

Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka.
Document Type
Article
Source
Cardiology Research & Practice. 7/30/2020, p1-8. 8p.
Subject
*CORONARY heart disease risk factors
*HYPERTENSION epidemiology
*AGE distribution
*BLOOD sugar
*CONFIDENCE intervals
*CORONARY disease
*DIABETES
*FASTING
*HYPERLIPIDEMIA
*LOW density lipoproteins
*MEDICAL protocols
*REGRESSION analysis
*RISK assessment
*SEX distribution
*SMOKING
*DISEASE prevalence
*ACUTE coronary syndrome
*HOSPITAL mortality
*ODDS ratio
Language
ISSN
2090-8016
Abstract
Objective. To assess sex-based differences in the prevalence of risk factor, their management, and differences in the prognosis among acute coronary syndrome (ACS) in Sri Lanka. Methods. Patients diagnosed with ACS were recruited from hospitals throughout the island. The Joint European Societies guidelines were used to assess recommended targets for coronary heart disease risk factors, and the GRACE score was used to assess the post-ACS prognosis. Age-adjusted regression was performed to calculate odds ratios for men versus women in risk factor control. Results. A total of 2116 patients, of whom 1242 (58.7%) were men, were included. Significant proportion of women were nonsmokers; OR = 0.11 (95% CI 0.09 to 0.13). The prevalence of hypertension (p < 0.001), diabetes (p < 0.001), and dyslipidemia (p = 0.004) was higher in women. The LDL-C target was achieved in a significantly higher percentage of women (12.6%); OR = 0.33 (95% CI 0.10 to 1.05). When stratified by age, no significant differences were observed in achieving the risk factor targets or management strategies used except for fasting blood sugar (p < 0.05) where more men achieved control target in both age categories. Majority of the ACS patients had either high or intermediate risk for one-year mortality as per the GRACE score. In-hospital and 1-year mean mortality risk was significantly higher among men of less than 65 years of age (p < 0.05). Conclusions. Smoking is significantly lower among Sri Lankan women diagnosed with ACS. However, hypertension, diabetes, and dyslipidemia were more prevalent among them. There was no difference in primary and secondary preventive strategies and management in both sexes but could be further improved in both groups. [ABSTRACT FROM AUTHOR]