Influence of sex on the profile of acute coronary syndrome: a tertiary care hospital based study from the Sub-Himalayan region in North India

Dhiraj Kapoor, Pankaj Gupta, Tushar Sontakke, Vishnu Agarwal, Shyam Sunder, Rupinder Sharma, Vineet Jearth


Background: Coronary events presents about ten years later in women than men. There exist distinct gender differences in terms of presentation of symptoms, validity of diagnostic tests and complications.

Methods: The study was conducted in the department of medicine R.P. Govt. Medical College (RPGMC) Himachal Pradesh. Consecutive 300 patients of acute coronary syndrome from June 2011 to June 2012 were included in the study. Demographical profile was recorded with focused clinical examination and relevant investigation with lipid profile was done.

Results:Among the study population of 300 individuals, 201 (67%) were males and 99 (33%) were females. The mean age among male patients was 61.3±11.7 years and in female patients the mean age was 65.6±11.20 years. 68.8% of females presented after 60 yrs of age. Dyslipidemia was the commonest risk factor followed by hypertension and obesity. 12.2% of female patients were smokers. Chest pain was the commonest presenting symptom seen in 82% cases. There was mean delay of 31.0±54.5 hrs in the presentation of females for treatment. ST Elevated Myocardial Infarction occurred less frequently in females.

Conclusions: Acute coronary syndrome is more age dependent in females. The predominance of dyslipidemia, hypertension and obesity as risk factors gives a message for primary care physicians to create awareness for the prevention of Acute Coronary Syndrome. The atypical symptoms should be recognised early which should further prevent the delay in presentation.



Acute coronary syndrome, Sub-Himalayan, Women, Atypical, Delay

Full Text:



Gaziono J M. Global burden of cardiovascular disease. Braunwald’s Heart Disease: A Text Book Of Cardiovascular Medicine. 7th Edition. Zipes D P, Libby P, Bonow R O, Braunwald E. Saunders. 2005: P1.

K. Srinath Reddy. Cardiovascular Disease In Non-Western Countries. N Engl J Med 2004;350:2438-2440.

Elliot M Antman, Eugene Braunwald. ST-Segment Elevation Myocardial Infarction. Harrison’s Principles of Internal Medicine, 17th Edition. Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, Loscalzo. Mc Graw Hill. 2008:P1532-37.

Pandey S. A prospective study of Myocardial Infarction patients admitted in a tertiary care hospital of south-eastern Rajasthan. Int J Biol Med Res. 2012; 3(2): 1694-1696.

Mandelzweig L, Battlera, Boyko V. The Second Euro Heart Survey on Acute Coronary Syndromes. Characteristics, treatment and outcome of patients with acute coronary syndrome in Europe and The Mediterranean Basin in 2004. Eur Heart J 2006;27: 2285-93.

Singh V, Deedwania P. Dyslipidemia in special populations: Asian Indians, African Americans, and Hispanics. Curr Atheroscler Rep 2006;8:32-40.

Vivek N. Dhruva, Samir I. Abdelhadi, Ather Anis, William Gluckman, David Hom, William Dougan, Edo Kaluski, Bunyad Haider, Marc Klapholz. ST-Segment Analysis Using Wireless Technology in acute myocardial infarction (STAT-MI) Trial. J Am Coll Cardiol 2007;50:509-13.

V Jacob Jose, Satya N Gupta. Mortality and morbidity of acute ST segment elevation in the current era. Indian Heart J 2004;56:210-214.

M P Holay, A Jandandhu, A Javahirani, M S Pandharipande and S D Suryawanshi. Clinical profile of acute myocardial infarction in the elderly. J Assoc Physician India 2007;55:188-192.

Kumar N, Sharma S, Mohan B, Beri A, Aslam N, Sood N, et al. Clinical and angiographic profile of patients presenting with first acute myocardial infarction in a tertiary care center in northern India. Indian Heart J 2008;60:210-4.

Memon MA, Samad A. Acute myocardial infraction in women. Pak J Cardiol 1999;10:95-107.

Chowta KN, Prijith PD, Chowtha MN. Modes of presentation of acute myocardial infraction. Indian J Crit Care Med 2005;9:151-4.