Homocysteine and clinical risk factor profile of Filipino survivors of non-st elevation myocardial infarction and unstable angina: Implications from the finest study .
- Author:
Jose B NEVADO JR
;
Marcelo Severino B IMASA
- Publication Type:Journal Article, Original
- Keywords: FilipinosNon-st Elevation Myocardial Infarction
- MeSH: Homocysteine; Angina, Unstable; Myocardial Infarction
- From: Philippine Journal of Internal Medicine 2007;45(4):179-184
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND: Unstable angina and non-ST elevation myocardial infarction (NSTEMI) are common acute coronary events with serious clinical sequelae. However, clinical profiles are scarce, particularly in Filipinos.
OBJECTIVE: The aim of this study is to determine the clinical risk factor profiles (age, diabetes, smoking, hypertension, dyslipidemia and homocysteine levels) of Filipino survivors of unstable angina and NSTEMI.
METHODOLOGY: From August, 2003 to September, 2006, 240 subjects with unstable angina (intermediate-and high-risk) or NSTEMI with onset in the past 2 weeks were screened and included in a randomized controlled trial on folic acid supplementation. The participants were interviewed and blood test for lipid profile and homocysteine were done.
RESULTS: The mean age is 59.4 +/- 10.1 years, with males at 57.4 +/- 10 years, and female at 62.1 +/- 9.7 years. Subjects are found to be mostly males (57.8 percent), hypertensive (66.7 percent), with significant smoking history (85.6 percent) and, for most women, menopausal (89.2 percent). Most subjects were diagnosed to have intermediate-risk unstable (45.4 percent), followed by NSTEMI (37.1 percent), then high-risk unstable angina (17.5 percent). More men had at least a previous acute coronary event than women (45.3 percent vs. 80.2 percent, p=0.0004). About 85 percent has 2 or more risk factors. The mean homocysteine levels is 12.8 umol/li with 16.4 percent > 16 umol/li. Increased body mass index was associated with unstable angina than NSTEMI, while homocysteinemia was associated more with NSTEMI.
CONCLUSION: Most Filipinos in hospitals in Metro Manila who survived non-ST elevation acute coronary syndrome are typically about 60 years old, male, with significant smoking history, and, for women, menopausal. About one-fifth has high homocysteine levels, which is associated with poorer prognosis.