Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka
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 gui...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/4560218 |
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| author | Priyadarshani Galappatthy Vipula Bataduwaarachchi Priyanga Ranasinghe Gamini Galappatthy Upul Senerath Chandrika Wijeyaratne Ruwan Ekanayake |
| author_facet | Priyadarshani Galappatthy Vipula Bataduwaarachchi Priyanga Ranasinghe Gamini Galappatthy Upul Senerath Chandrika Wijeyaratne Ruwan Ekanayake |
| author_sort | Priyadarshani Galappatthy |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-4f63b0d8ffac4feb9db4cb9513090ccd |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-4f63b0d8ffac4feb9db4cb9513090ccd2025-02-03T01:27:57ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/45602184560218Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri LankaPriyadarshani Galappatthy0Vipula Bataduwaarachchi1Priyanga Ranasinghe2Gamini Galappatthy3Upul Senerath4Chandrika Wijeyaratne5Ruwan Ekanayake6Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri LankaDepartment of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri LankaDepartment of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri LankaMinistry of Health, Nutrition and Indigenous Medicine, Colombo, Sri LankaDepartment of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri LankaDepartment of Gynecology and Obstetrics, Faculty of Medicine, University of Colombo, Colombo, Sri LankaSri Lanka Heart Association, Colombo, Sri LankaObjective. 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.http://dx.doi.org/10.1155/2020/4560218 |
| spellingShingle | Priyadarshani Galappatthy Vipula Bataduwaarachchi Priyanga Ranasinghe Gamini Galappatthy Upul Senerath Chandrika Wijeyaratne Ruwan Ekanayake Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka Cardiology Research and Practice |
| title | Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka |
| title_full | Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka |
| title_fullStr | Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka |
| title_full_unstemmed | Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka |
| title_short | Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka |
| title_sort | sex difference in risk factors grace scores and management among post acute coronary syndrome patients in sri lanka |
| url | http://dx.doi.org/10.1155/2020/4560218 |
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