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Prevalence of Acute Coronary Syndrome and Various Risk Factors in Acute Stroke Patients
Muhammad Humayoun Rashid1,2, Ghulam Yaseen1, Umar Ghaffar1
1Internal Medicine, Nishtar Medical University, Multan, PAK.
Insights
Acute coronary syndrome (ACS) is common in acute stroke patients, affecting 57%. Managing ACS is crucial to prevent strokes, a leading cause of death and disability worldwide.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Stroke is a leading global cause of death, sharing risk factors with acute coronary syndrome (ACS).
- Patients with ACS face a higher risk of recurrent ischemic events, including stroke.
- Understanding the prevalence of underlying ACS in stroke patients is vital for risk stratification and prevention.
Purpose of the Study:
- To determine the prevalence of underlying acute coronary syndrome (ACS) in patients presenting with acute stroke.
- To identify the prevalence of common cardiovascular risk factors among acute stroke patients.
Main Methods:
- A cross-sectional study involving 160 acute stroke patients at two Pakistani medical institutions.
- Data collection included detailed history, physical examinations, and questionnaires.
- Prevalence of ACS and risk factors like hypertension, diabetes, dyslipidemia, and smoking were assessed.
Main Results:
- Over half of acute stroke patients (57%) had underlying ACS, including unstable angina, NSTEMI, and STEMI.
- Hypertension (63%), lack of exercise (57%), smoking (44%), diabetes (38%), and dyslipidemia (31%) were prevalent risk factors.
- The majority of patients were over 50 years old, with a male predominance.
Conclusions:
- Acute coronary syndrome is a frequent comorbidity in patients with acute stroke.
- Effective management of ACS is essential for preventing stroke and its severe consequences.
- This highlights the need for integrated cardiovascular care pathways.
Abstract:
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.
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