A Prospective Observational Study on Acute Coronary Syndrome: Exploring Knowledge, Attitude and Practice Gaps in Women Regarding Symptoms, Risk Factors and Treatment Options
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Abstract
Acute Coronary Syndrome (ACS) remains a significant global health issue, disproportionately affecting women due to delayed recognition, misdiagnosis, and under-treatment. This study aims to assess the knowledge, attitude, and practice (KAP) gaps in women regarding ACS symptoms, risk factors, and treatment. Conducted as a six-month prospective observational study at Vivekananda Super Speciality Hospital, 170 women diagnosed with ACS participated. The results highlighted that hypertension and diabetes were the most common risk factors, while chest pain was the predominant symptom. Initial assessments showed that most participants had average knowledge (53%), while 51% had poor overall KAP scores. However, post-intervention follow-up demonstrated substantial improvements, with good knowledge increasing from 13% to 36% and good KAP scores rising from 3.6% to 37.7%. Quality of Life (QOL) scores also improved significantly. These findings underscore the need for targeted educational initiatives and gender-sensitive approaches to ACS diagnosis and management. Addressing Yentl Syndrome and enhancing awareness could reduce ACS-related morbidity and mortality in women.
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1. Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016;4(13):256. Available from: https://doi.org/10.21037/atm.2016.06.33
2. O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. J Am Coll Cardiol. 2013;61(4):e78-e140. Available from: https://www.jacc.org/doi/abs/10.1016/j.jacc.2012.11.019
3. Ross R, Glomset JA. Atherosclerosis and the arterial smooth muscle cell. Science. 1976;193(4251):1094-1100.
4. Topol EJ, Bhatt DL. Acute coronary syndromes: Clinical diagnosis and treatment. Lancet. 2004;363(9410):1075-1085.
5. Sakamoto A, Cornelissen A, Sato Y, Mori M, Kawakami R, Kawai K, et al. Vulnerable plaque in patients with acute coronary syndrome: Identification, importance, and management. US Cardiol. 2022 Jan 26;16:e01. Available from: https://doi.org/10.15420/usc.2021.22
6. Li X, Yan F, Liu X, Li M, Li J, Chen Y, et al. Acute coronary syndrome screening in patients presenting with arteriosclerosis in health check-ups: A case-control study. BMJ Open. 2023 Aug 21;13(8):e062596. Available from: https://doi.org/10.1136/bmjopen-2022-062596
7. Canto JG, Hand MM, Bonow RO, Sopko G, Pepine CJ, et al. Symptom presentation of women with acute coronary syndrome: Myth versus reality. Circulation. 2011;124(13):1415-1425.
8. American Heart Association. American Heart Association [Internet]. Dallas (TX): American Heart Association. Available from: https://www.heart.org/
9. Colhoun HM. Cardiovascular disease in diabetes. Lancet Diabetes Endocrinol. 2014;2(1):8-18.
10. Mendis S. Global status report on noncommunicable diseases. World Health Organization; 2011. Available from:
11. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002 Mar 5;105(9):1135-43. Available from: https://doi.org/10.1161/hc0902.104353
12. Ford ES. Age and coronary heart disease: The role of inflammation. Circulation. 2011;124(6):719-721.
13. Steptoe A, Kivimäki M. Stress and cardiovascular disease. Nat Rev Cardiol. 2013;10(6):369-380. Available from: https://www.nature.com/articles/nrcardio.2012.45
14. Reynolds K. Alcohol consumption and risk of coronary heart disease: A meta-analysis. JAMA. 2003;289(5):576-583.
15. Blumenthal JA, Smith PJ. Psychological risk factors in cardiovascular disease. Curr Psychiatry Rep. 2014;16(9):478.
16. Gibbons RJ. Diagnosis and treatment of chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2003;107(1):149-158.
17. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A pathophysiologic approach. 9th ed. McGraw-Hill Education; 2014.
18. Gulati M. Yentl’s Bikini: Sex differences in STEMI. J Am Heart Assoc. 2019 May 21;8(10). Available from: https://doi.org/10.1161/jaha.119.012873
19. Wolpert S. Yentl syndrome: A deadly data bias against women. Longreads. 2019 Jun 21 [cited 2024 Sep 5]. Available from: https://longreads.com/2019/06/21/yentl-syndrome-a-deadly-data-bias-against-women/
20. Vaina S, Milkas A, Crysohoou C, Stefanadis C. Coronary artery disease in women: From the Yentl syndrome to contemporary treatment. World J Cardiol. 2015;7(1):10-18. Available from: https://doi.org/10.4330/wjc.v7.i1.10