Browsing by Author "Harshanie, R.L.P."

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    Gender based differences in acute coronary syndrome
    (Sri Lanka Medical Association, 2011) Danansuriya, D.S.T.; Alexander, M.A.F.; Harshanie, R.L.P.; Gammulla, S.P.K.H.M.A.T.; Pemarwansa, G.; Thirumavalan, K.; Samarakoon, S.M.S.B.; de Silva, A.P.; de Silva, S.T.; Ranawaka, U.K.
    INTRODUCTION AND OBJECTIVES: To describe gender based differences in demographics, risk factors, management and early outcome in Sri Lankan patients with acute coronary syndromes (ACS). Methods: All adults admitted with ACS to medical units of Colombo North Teaching Hospital are enrolled in a prospective Registry. We studied data obtained from patients admitted over a period of 11/2 years. RESULTS: 765 patients were studied (56.9% males). Females were likely to be older [mean age years (SD) - male 59.5(11.4), female 62.9(11.4), pO.OOl]. Women were more likely to have unstable angina (female -56.4%, male- 40,0%)7 while men were more likely to have ST elevated myocardial infarction (M-36.6%? 19.4%) (pO.OOl). Several risk factors were commoner in women (p<0.001): hypertension-female- 70%, male- 49.6%; diabetes - female- 49.7%, male- 35.6%; hyperlipidaemia - female-73.6%, male-56.6%; high waist circumference- female 65.8%, male-29.8%. Smoking and alcohol use were almost exclusively seen in men (75.9% and 84.6% respectively vs. 1.2% and 1.5%; /K0.001). 32.4% of women and 37.6% of men had previous IHD (p=0.079). Women were more likely to be on pre-admission antiplatelet, statin, beta blocker and ACE inhibitor therapy (/7<0.005). Five patients died. There were no differences in care given and early outcome. CONCLUSIONS: There are important gender-related differences in the pattern of ACS in Sri Lankan patients. Several modifiable cardiovascular risk factors were commoner in women, highlighting the need for targeted preventive strategies. Acknowledgements: Japan International Cooperation Agency
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    Pre-admission antiplatelet therapy in patients presenting with acute coronary syndrome
    (Sri Lanka Medical Association, 2011) Fonseka, V.N.R.M.; Danansuriya, D.S.T.; Harshanie, R.L.P.; Harshini, M.L.; Thirumavalan, K.
    INTRODUCTION AND OBJECTIVES: Some patients who present with acute coronary syndrome (ACS) are on prophylactic antiplatelet therapy prior to hospital admission. This study aims to describe factors associated with pre-admission antiplatelet use in patients with ACS admitted to a tertiary care setting. METHODS: With informed consent, data was gathered from patients diagnosed with ACS at the Colombo North Teaching Hospital over 18 months, using a validated questionnaire. Demographic data, risk factors, management and early outcome were analysed using SPSS 17. RESULTS: 254 (33.2%) of a total of 765 patients were on antiplatelet therapy prior to hospital admission. 62/254 (24.5%) were on primary prophylaxis, while 192/254 (75.5%) were on secondary prophylaxis for coronary artery disease (CAD). Although 265 patients had a history of CAD, only 192 (72.4%) were on secondary prophylaxis. Most (115/192 - 59.9%) were on two antiplatelet agents at the time they developed ACS this time. The commonest risk factor for commencing primary prophylaxis was diabetes mellitus (47/62 - 75.8%), and most (52/62 - 83.9%) were on a single anti-platelet agent. Early outcome (death, recurrent ACS) was not significantly associated with pre-admission use of antiplatelet agents as primary or secondary prophylaxis. CONCLUSIONS: A quarter of the patients with pre-existent CAD were not on any antiplatelet agent. One-third of patients developed ACS while on antiplatelet therapy. This highlights the need for better strategies for prevention of ACS. Acknowledgements: Japan International Cooperation Agency.