Gender Based Differences in Risk Factor Profile and Coronary Angiography of Patients Presenting with Acute Myocardial Infarction in North Indian PopulationCorrespondence Address :
Dr. Supriya Bajaj,
C/o Dr. Sumit Grover, Assistant Professor, Department of Pathology, Dayanand Medical College and Hospital,
Ludhiana, Punjab-141001, India.
Introduction: Coronary Artery Disease (CAD) among women presents atypically with atypical chest pain, neck pain, nausea, fatigue and dyspnoea. Co-existing co-morbidities such as Diabetes Mellitus (DM) and hypertension along with difference in risk factor prevalence makes it necessary to have a gender specific approach.
Aim: To study gender specific differences in diagnosing and treating Acute Myocardial Infarction (AMI) in North Indian population.
Materials and Methods: Fifty consecutive men and women presenting with AMI were studied. A detailed history including symptoms, history of DM, hypertension, smoking and dyslipidaemia was obtained. ECG, evaluation of cardiac enzymes (CPK-MB, Troponin I), RBS, lipid profile, two dimensional transthoracic echocardiography and coronary angiography were performed. The data was statistically analysed.
Results: Among 100 patients (50 males and females each), we found a later age at presentation (62 y vs 56.5 y) and higher prevalence of diabetes (52% vs 24%, p=0.004) and hypertension (46% vs 28%) among females but more dyslipidaemia (34% vs 26%), smoking (44% vs 0%, p=0.0) and higher BMI (25.58 vs 23.74, p=0.019) among males. More females presented with atypical symptoms (16% vs 6%) and were detected to have insignificant CAD (14% vs 2%) than males.
Conclusion: North Indian women with presentation at a later age, with atypical symptoms, more incidences of risk factors such as diabetes and hypertension along with lesser dyslipidaemia and BMI than males need a higher index of suspicion while evaluating them for CAD. Misdiagnosis is more likely because of atypical presentation. A milder disease on angiography and a lower incidence of multiple vessel disease is a common finding. We recommend more and larger Indian studies to acquire more data so that this growing prevalence of CAD in women can be curbed.
Atypical, Coronary artery disease symptoms, Diabetes, Dyslipidaemia, Hypertension, Sex differences
Supriya Bajaj, Vijay Mahajan, Sumit Grover, Amit Mahajan, Nipun Mahajan. GENDER BASED DIFFERENCES IN RISK FACTOR PROFILE AND CORONARY ANGIOGRAPHY OF PATIENTS PRESENTING WITH ACUTE MYOCARDIAL INFARCTION IN NORTH INDIAN POPULATION. Journal of Clinical and Diagnostic Research [serial online] 2016 May [cited: 2018 Oct 16 ]; 10:OC05-OC07. Available from
Date of Submission: Aug 27, 2015
Date of Peer Review: Nov 03, 2015
Date of Acceptance: Jan 31, 2016
Date of Publishing: May 01, 2016
Financial OR OTHER COMPETING INTERESTS: None.
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2016: 132.37
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase & EMbiology
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)