Annals of African Medicine
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ORIGINAL ARTICLE
Year : 2022  |  Volume : 21  |  Issue : 1  |  Page : 8-15

Comparative study of acute coronary syndrome in postmenopausal women and age-matched men: A prospective cohort study in Southern India


1 Department of Cardiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand; Department of Medicine, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India
2 Department of Endocrinology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
3 Department of Cardiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
4 Department of Medicine, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India

Correspondence Address:
Ashwin Kodliwadmath
Department of Cardiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aam.aam_38_20

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Background: Acute coronary syndrome (ACS) differs in women and men with respect to risk factors, clinical presentation, complications and outcome. The major reason for the differences has been the effect of estrogen which protects women from coronary artery disease (CAD) till menopause. Women develop CAD one decade later than men. Hence, we compared the profile of ACS in postmenopausal women with age-matched men to see, does the difference still exist. Materials and Methods: Comparative prospective study of 50 postmenopausal women as study group and fifty age-matched men as a control group diagnosed with ACS, who were admitted in a medical college hospital from December 2013 to September 2015. Chi-square test and Student's t-test have been used to find the significant association of study parameters between women and men. Results: Chest pain was the main complaint in the majority of the women (76%) and men (88%). Radiation of chest pain (60%) and sweating (72%) were significantly present in men compared to women (24% and 26%, respectively), whereas breathlessness was significantly present in women (40%) compared to men (16%). Women had later presentation to the hospital after symptom onset compared to men. Women had a higher respiratory rate (22.02 cycles/min) compared to men (20 cycles/min) and more crepitations compared to men. Men had more ventricular tachycardia (14%) and intracerebral hemorrhage (4%), whereas women had all other complications more than or same as men and higher in-hospital mortality (14%) compared to men (8%). Conclusion: Postmenopausal women with ACS had more atypical presentation of symptoms, later presentation to hospital, more tachypnea, more crepitations, more complications, and higher in-hospital mortality compared to men of the same age group. The difference in the profile of ACS continues to exist even after menopause and age matching.


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