title: Acute coronary syndrome among patients with chest pain: Prevalence, incidence and risk factors.
abstract: BACKGROUND
  Urbanization and adoption of new diet and lifestyles had increased the cardiovascular risk factor (CVRF) rate and therefore, acute coronary syndrome (ACS) in developing countries such as Tunisia. We aimed at determining ACS prevalence among a sample of Tunisian patients with chest pain, at establishing the standardized incidence rate (SIR) of ACS, and at quantifying the relationship between ASC and CVRF in this population.
  
  
  METHODS
  We studied 3158 patients admitted to a chest pain unit for non-traumatic chest pain collected in Emergency Data from January 2012 to December 2014. For all patients, the data were collected using a standardized form. We performed univariate rather than multivariate logistic regression analyses to identify age and gender-related CVRF in ACS. Linear interpolation was used for curve estimation.
  
  
  RESULTS
  707 (22.3%) chest pain patients were classified as ACS. The age-SIR per 10(-5)personyear (PY) was 85.7; it was 112.6 in men and 45.3 in women. Eighty one percent of patient with ACS cumulated 2 CVRF and more. The highest odds ratio were 2.00 (95% CI 1.64-2.44) for diabetes and 1.81 (95% CI 1.50-2.18) for active smoking. ACS in elderly patients was significantly associated with active smoking (OR: 2.36), diabetes (OR: 1.72) and personal ACS history (OR: 1.71). We found a significant and very high linear relation between the number of CVRF and ACS odds ratio (R(2)=0.958).
  
  
  CONCLUSIONS
  Our results showed that the incidence of ACS in a Tunisian population is not very different from what is observed in developed countries; with a close relation with CVRF especially diabetes and smoking.
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: drbaccouchehouda@hotmail.fr.
authors.forename: Houda
authors.initials: H
authors.lastname: Baccouche
authors.affiliation: Department of Epidemiology and Preventive Medicine, University Hospital of Monastir, Tunisia. Electronic address: belguith_asma@yahoo.fr.
authors.forename: Asma Sriha
authors.initials: AS
authors.lastname: Belguith
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: hamdiboubaker@hotmail.fr.
authors.forename: Hamdi
authors.initials: H
authors.lastname: Boubaker
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: grissa.med.habib@gmail.com.
authors.forename: Mohamed Habib
authors.initials: MH
authors.lastname: Grissa
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: wahid.bouida@rns.tn.
authors.forename: Wahid
authors.initials: W
authors.lastname: Bouida
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: beletaief.kaouther@yahoo.fr.
authors.forename: Kaouthar
authors.initials: K
authors.lastname: Beltaief
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: adelsekma@hotmail.fr.
authors.forename: Adel
authors.initials: A
authors.lastname: Sekma
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: nizarfredj@gmail.com.
authors.forename: Nizar
authors.initials: N
authors.lastname: Fredj
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: medecinasri@gmail.com.
authors.forename: Nasri
authors.initials: N
authors.lastname: Bzeouich
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: zinazied@gmail.com.
authors.forename: Zied
authors.initials: Z
authors.lastname: Zina
authors.affiliation: Emergency Department, Sahloul University Hospital, Sousse, Tunisia. Electronic address: riadh.boukef@rns.tn.
authors.forename: Riadh
authors.initials: R
authors.lastname: Boukef
authors.affiliation: Department of Epidemiology and Preventive Medicine, University Hospital of Monastir, Tunisia. Electronic address: Mohamed.soltani@rns.tn.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Soltani
authors.affiliation: Research Laboratory (LR12SP18), University of Monastir, Tunisia. Electronic address: semir.noiura@rns.tn.
authors.forename: Semir
authors.initials: S
authors.lastname: Nouira
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002637:Chest Pain / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014416:Tunisia / Q000453:epidemiology
keywords: Acute coronary syndrome; Chest pain; Epidemiology; Incidence; Prevalence; Risk factors