Abstrait

Young acute coronary syndrome outcomes in heterogenous Asians.

Nicholas Chua Yul Chye*, Rizmy Najme Khir, Lim Chiao Wen, Johan Rizwal Ismai, Effa Abdul Rahman, Hafisyatul Aiza, Khairul Shafiq Ibrahim, Faridah Embong, Christopher Lee, Mohd Kamal Mohd Arshad, Sazzli Kasim, Chong Pei Feng

Background: Recently, more patients are presenting at a younger age with acute coronary syndrome (ACS). Objective: Identify the demographics, risk factors and outcomes of young ACS North of Kuala Lumpur, Malaysia. Materials and Methods: This was a prospective, observational study conducted in Sungai Buloh Hospital, North of Kuala Lumpur, Malaysia. Patients were enrolled during 2014 and 2015. Results: There was 1479 ACS, with a mean age of 56 ± 12. 10.6% (n=158) were below 40, with a mean age of 34 with the youngest at 17. Meanwhile 15.8% (n=25) were female. Ethnicity breakdown revealed 62% Malays, 24.1% Indians, 1.2% Chinese and 12.7% of other races. ACS subtypes showed 56.9% unstable angina (UA), 22.2% non-ST elevation myocardial infarction (NSTEMI) and 20.9% ST elevation myocardial infarction (STEMI). Cardiovascular risk factor assessment revealed 46.2% hypertension, 43.0% smokers, 6.3% ex-smokers, 29.7% known ischemic heart disease (IHD), 24.7% diabetes mellitus, 22.8% dyslipidemia, 19.0% positive family history of IHD and 10.8% alcohol consumption. Biochemical analysis showed fasting glucose level of 7.2 ± 3.5 mmol/L and serum creatinine 84.0 ± 23.5 μmol/L. Lipid profile revealed mean total cholesterol of 4.9 ± 1.4 mmol/L, triglyceride 2.2 ± 1.3 mmol/L, HDL 0.9 ± 0.4 mmol/L, and LDL of 3.3 ± 1.1 mmol/L. 30-day mortality was 3.2% while 90-day mortality was 4.5%. Conclusion: Majority of young ACS were male with positive risk factors such as hypertension and cigarette smoking.