Rashid Muhammad Humayoun, Yaseen Ghulam, Ghaffar Umar, Khan Ahmad Ali, Kabir Ahmad, Aisha Azka, Komel Aqsa
Internal Medicine, Nishtar Medical University, Multan, PAK.
Cardiology, Ch. Pervaiz Elahi Institute of Cardiology, Multan, PAK.
Cureus. 2020 Aug 4;12(8):e9552. doi: 10.7759/cureus.9552.
Background Stroke is the second leading cause of death worldwide after acute coronary syndrome (ACS). Both diseases share many risk factors such as hypertension, diabetes, dyslipidemia, and smoking. Patients who experience acute coronary syndrome are at heightened risk of recurrent ischemic events such as ischemic strokes, one of the most feared cardiovascular events because of the risk of long-term disability. We tried to estimate the prevalence of underlying ACS among patients with acute stroke. Methods This cross-sectional study was done at the CPE Institute of Cardiology, Pakistan, and Nishtar Medical University and Hospital, Pakistan. A total of 160 acute stroke cases were selected by consecutive sampling technique and questionnaire forms were filled. Detailed history, investigations, and physical examinations were done. The primary outcome was the prevalence of ACS and secondary outcomes were the prevalence of hypertension, smoking, dyslipidemia, diabetes mellitus, and previous history of stroke in stroke patients. Results Most of the patients that presented to us were above 50 years of age with the mean age of 62 years (SD = 9.23 years). Male predominance was seen with a total of 115 (72%) cases. Out of 160 patients, 91 (57%, p < 0.05) had underlying ACS, with 45 cases (49%) with unstable angina, 20 (22%) with non-ST-elevation myocardial infarction (NSTEMI), and 26 (29%) with ST-elevation myocardial infarction (STEMI). Prevalence of risk factors in 160 cases were, hypertension (101, 63%), lack of exercise (91, 57%), smoking (70, 44%), diabetes mellitus (61, 38%), dyslipidemia (50, 31%). All these results were statistically significant (p < 0.05). Prevalence of obesity (35, 22%) and previous stroke history (19, 12%) was statistically insignificant (p > 0.05). Conclusion Acute coronary syndrome is still frequently present in patients with acute stroke. The need of the hour is to manage ACS efficiently so that its deadly complications such as stroke can be prevented.
中风是全球仅次于急性冠状动脉综合征(ACS)的第二大死因。这两种疾病有许多共同的危险因素,如高血压、糖尿病、血脂异常和吸烟。经历急性冠状动脉综合征的患者发生复发性缺血性事件(如缺血性中风)的风险增加,缺血性中风是最可怕的心血管事件之一,因为存在长期残疾的风险。我们试图估算急性中风患者中潜在ACS的患病率。
这项横断面研究在巴基斯坦的CPE心脏病学研究所和巴基斯坦的尼什塔尔医科大学及医院进行。通过连续抽样技术选取了160例急性中风病例,并填写了问卷。进行了详细的病史询问、检查和体格检查。主要结局是ACS的患病率,次要结局是中风患者中高血压、吸烟、血脂异常、糖尿病以及既往中风病史的患病率。
前来就诊的大多数患者年龄在50岁以上,平均年龄为62岁(标准差=9.23岁)。男性占优势,共有115例(72%)。在160例患者中,91例(57%,p<0.05)有潜在ACS,其中45例(49%)为不稳定型心绞痛,20例(22%)为非ST段抬高型心肌梗死(NSTEMI),26例(29%)为ST段抬高型心肌梗死(STEMI)。160例患者中危险因素的患病率分别为:高血压(101例,63%)、缺乏运动(91例,57%)、吸烟(70例,44%)、糖尿病(61例,38%)、血脂异常(50例,31%)。所有这些结果均具有统计学意义(p<0.05)。肥胖患病率(35例,22%)和既往中风病史患病率(19例,12%)无统计学意义(p>0.05)。
急性中风患者中急性冠状动脉综合征仍然很常见。当前迫切需要有效管理ACS,以预防其致命并发症如中风。