Vol. 45 | No. 1 | January-June 2017 Back

Open Access

Obstructive CAD in Filipino Women vs Men Diagnosed with ACS in the Philippine ACS Registry

Abstract

Introduction: To date, no study in published literature has investigated the prevalence of obstructive coronary  artery disease (CAD) among Filipino women diagnosed with ACS. This is a pilot study. 

Objectives: To determine the prevalence of obstructive CAD among Filipino women and categorize them as  ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), or unstable angina (UA);  and to determine the risk factors associated with acute coronary syndrome (ACS) among Filipino  women in terms of age, smoking history and comorbidities, in comparison with Filipino men. 

Methods: This is a cross-sectional study performed from November 2011 through September 2015 using  information from patients listed at Philippine ACS Registry of the Philippine Heart Association. The  collected data included demographic information such as sex, age, smoking history, comorbidities,  medical management, cardiac procedures and mortality. 

Results: The study population was composed of 3,346 patients, 31.6% (n=1,059) of whom were females.  Out of the 1,169 (34.9%) patients who underwent cardiac catheterization, 25.8% (n=302) were  females. All these female patients who underwent cardiac catheterization—whether diagnosed with  STEMI (n=133), NSTEMI (n=131), or UA (n=38)—had single- or multiple-vessel disease. In the  overall study population, the risk factors that showed statistically significant association with ACS  (p<0.05) were age (mean age 59.39 vs 66.60 years), hypertension (73.9% vs 80.5%), diabetes (36.1%  vs 42.9%), smoking history (67.8% vs 15.6%), prior MI (11.0% vs 8.6%), previous catheterization  (3.5% vs 2.1%) and history of transient ischemic attach (TIA; 1.4% vs 1.0%). 

Conclusion: There was a 100% prevalence of obstructive CAD among Filipino women who underwent cardiac  catheterization with a diagnosis of STEMI, NSTEMI, or UA. Hypertension and diabetes were more  prevalent among women, while smoking history, prior MI, previous catheterization, and history of  TIA were more prevalent among the men. Men diagnosed with ACS were younger than the women.

 

  1. WHO. Global Status Report on Noncommunicable Diseases 2014.  Switzerland: World Health Organization; 2014. 
  2. Philippines: coronary heart disease. World Health Rankings Web  site. http://www.worldlifeexpectancy.com/philippines-coronary heart-disease. Published on May 2014. Accessed on July 28, 2017. 
  3. Mann DL, Zipes DP, Libby P, Bonow RO. Braunwald’s Heart  Disease: A Textbook of Cardiovascular Medicine. 10th ed. Canada:  Elsevier; 2014. 
  4. Ryan C, Shaw R, Pliam M, et al. Coronary heart disease in Filipino  and Filipino-American patients: prevalence of risk factors and  outcomes of treatment. J Invasive Cardiol. 2000;12(3):134-9. 
  5. Matulac MO, Punzalan FER, Tiongco RHP, et al. Prevalence of  coronary artery disease among adult patients with congenital heart  disease who underwent coronary angiogram at the University of the  Philippines–Philippine General Hospital from September 1998 to  November 2011. Acta Med Phillip. http://actamedicaphilippina.com.ph/content/prevalence-coronary-artery-disease-among-adult patients-congenital-heart-disease-who-underwe. Submitted on  December 15, 2014. Accessed on July 28, 2017. 
  6. Zhang JW, He LJ, Cao SJ, Yang Q, Yang SW, Zhou YJ. Association  of serum uric acid and coronary artery disease in premenopausal  women. PloS One. 2014;9(9):e106130.  
  7. Lorenzo C, Williams K, Hunt KJ, Haffner SM. The National  Cholesterol Education Program - Adult Treatment Panel III,  International Diabetes Federation, and World Health Organization  definitions of the metabolic syndrome as predictors of incident  cardiovascular disease and diabetes. Diabetes Care. 2007;30(1):8-13. 
  8. Rosengren A, Wallentin L, Simoons M, et al. Cardiovascular risk  factors and clinical presentation in acute coronary syndrome. Heart.  2005;91(9):1141-7. 
  9. Majahalme SK, Smith DE, Cooper JV, et al. Comparison of  patients with acute coronary syndrome with and without systemic  hypertension. Am J Cardiol. 2003;92(3):258-63. 
  10. Bacci MR, Fonseca FL, Nogueira LF, et al. Predominance of  STEMI and severity of coronary artery disease in a cohort of patients  hospitalized with acute coronary syndrome: a report from ABC  Medical School. Rev Assoc Med Bras. 2015;61(3):240-3.

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