Abstract

Sensitivity and specificity of gensini and friesinger score among pre-and postmenopausal women with acute coronary syndrome: A hospital based study in Bangladesh

Author(s): Ayesha Siddika, Fazila-Tun-Nesa Malik, Mir Nesaruddin Ahmed, Nahidul Hasan, Nazir Ahmed, Mohammad Badiuzzaman, Dhiman Banik, Mir Ishraquzzaman, Md. Shamim Chowdhury, Md. Kalimuddin

Aim: Gensini score and friesinger score are an effective tool used to evaluate the severity of Coronary Artery Disease (CAD). The risk of coronary artery disease in women after menopause sharply rises in contrast to that of women before menopause because of hormonal protection against atherosclerosis. Post-menopausal women presented with more severe Coronary Artery Disease (CAD) along with multiple comorbidity.However, there are limited data describing the sensitivity and specificity of gensini and friesinger score between pre- and postmenopausal women with Acute Coronary Syndrome (ACS). This study aimed to assess the sensitivity and specificity of Gensini and Friesinger score between pre-and postmenopausal women with ACS.

Methods: In this cross sectional observational study a total of 140 female patients with acute coronary syndrome were enrolled. They were divided in Group-I (premenopausal) and Group-II (postmenopausal) on the basis of the state of menopause. The clinical data and coronary angiographic characteristics severity by Gensini and Friesinger score were compared between the premenopausal and postmenopausal ACS groups and then sensitivity and specificity were analyzed.

Results: Mean age of the premenopausal ACS patients was 41.53 ± 5.45 years and 57.23 ± 7.45 years in postmenopausal ACS patients which was statistically significant (p=0.001). Normal coronary angiogram and single vessel disease were more prevalent in premenopausal group (31.4% vs. 17.1%; p=0.04 and 31.4% vs. 15.7%; p=0.002) and triple vessel disease in postmenopausal group (48.6% vs. 20%; p=0.001). The mean Gensini score was higher in postmenopausal group than premenopausal group (56.1 ± 43.4 vs. 33.5 ± 36.9; p=0.001). High to intermediate Friesinger score (11-15) was found significantly higher in postmenopausal group than premenopausal group (2.9% vs. 1.4%; 72.9% vs. 50%; p=0.003). Sensitivity and specificity of Gensini and Friesinger score were (95.9 vs. 97.3); (73.7 vs. 64.2).

Conclusion: Normal coronary angiogram and single vessel disease were more prevalent in premenopausal group and triple vessel disease in postmenopausal group. Regarding the Severity assessment by Gensini score and Friesinger score revealed, Friesinger score was more sensitive but Gensini score was more specific.