Current Research: Cardiology

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Incidence and Criteria of Acute Coronary Syndrome among the Population of North Sinai Governorate

Author(s): Mohammad Gouda*, Ahmed S Ammar, Tarek A Naguib, Amr A Ateya and El-Sayed A Ibrahim

Background: Acute coronary syndromes (ACS) affect millions of individuals annually causing considerable morbidity and mortality, it remains the first killer in developed countries despite significant improvements in its management over the last several decades. Great importance of surveys as they provide a useful means of identifying variations in clinical practice and their effect on outcomes as well as reliable information on population incidence, prevalence, and case-fatality rates of coronary heart diseases (CAD) is essential for understanding, treating, and controlling the disease.

Aim of the work: Due to the privacy of the community in the governorate of North Sinai as coastal Bedouin environment where is little population number, less pollution and less stressful life, we aimed to find out the prevalence of ACS among the North Sinai population and identify the criteria of the disease in these patients.

Patient and methods: Our study included 258 patients of the North Sinai population who presented with ACS to El-Arish General Hospital, the only hospital providing cardiac health care to the North Sinai population. The study was carried out from March, 2012, to February, 2013. All patients presented with ACS (acute myocardial infarction or unstable angina) were included. Full history taking with stress on analysis of chest pain, scoring was done depending on physical activity, diet and stress. Full physical examination, ECG and Laboratory samples collected for cardiac markers, random blood sugar (RBS), serum uric acid and lipid profile.

Results: 105 cases (40.7%) had STEMI, 89 cases (34.5%) had UA, and 64 cases (24.8%) had NSTEMI. Annual prevalence, incidence, rate of 65/100,000 people in the whole governorate. Most of them, 223 cases (86.4%), are living in the urban region, El-Arish city, which has the highest annual prevalence, incidence, rate of 139/100,000 people. The rest, 35 cases (13.6%), are distributed in the rural regions with an annual prevalence, incidence, rate of 15/100,000 people. Mean age of the patients was 56.16 ± 10.83 years with BMI of 28.2 ± 3.7 and serum uric acid level of 5.2 ± 1.6. 197 patients (76.4%) were males and 61 (23.6%) were females. 122 patients (47.3%) were diabetic, 86 patients (33.3%) were hypertensive and 139 patients (53.9%) were dyslipidemic. 47 patients (18.2%) were having moderate stress during the year prior to the attack with 50% chance of developing an illness and only 3 patients (1.2%) suffered from severe stress with 90% chance of having an illness according to Holmes and Rahe stress scale.

The diet style of 99 patients (38.4%) were far away from the Mediterranean diet while the majority of the patients, 159 patients (61.6%), were closed to the Mediterranean diet.

Conclusion: We tried to draw a portrait of ACS in North Sinai Governorate through finding out the volume of the disease and its risk factors among the population. We've succeeded in finding out the most important and easiest modifiable risk factors which are the overweight and physical inactivity. In addition, Mediterranean diet style probable significance in ACS primary prevention.


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