The clinical spectrum of acute coronary syndromes: A study from tertiary care centre of Kumaun region of Uttarakhand

Singh, Yatendra; Satyawali, Vivekanand; Joshi, Arun; Joshi, S. C.; Khalil, Mohammed K.; Kumar, Jainendra

doi:10.4103/0189-7969.130076

Cited by 5 publications

(5 citation statements)

References 2 publications

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“…23 The electrocardiographic profile revealed anterior wall MI as the commonest presentation, followed by inferior wall MI, consistent with findings by Sidhu et al, 20 and Jose and Gupta et al 27 However, Singh et al reported a similar frequency of anterior and inferior wall MI among 492 patients in a tertiary care center in Uttarakhand. 28 In the present study, the majority of the patients were administered dual anti-platelet therapy and statins, similar to studies by Sidhu et al, 20 the CREATE registry, 23 and the ACCESS study. 22 Only 29.1% of our patients underwent thrombolysis, as per European Society of Cardiology 2017 guidelines.…”

Section: Discussionsupporting

confidence: 70%

Clinical profile and 30-day outcome of patients with acute coronary syndrome

Dutta,

Naruttam Sonowal,

Mech

et al. 2023

Asian J Med Sci

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Background: Acute coronary syndrome (ACS) accounts for a quarter of all-cause mortality, with substantial loss of productivity and socio-economic implications. Analyses of the clinical presentation, age- and gender-specific differences, and mortality pattern are decisive in determining the clinical outcome of a patient. Aims and Objectives: The primary objective was to determine the in-hospital and 30th day outcomes in patients with ACS. The secondary objectives were to study cardiometabolic risk factors, the clinical presentation, and the clinical course of the patients with ACS during hospitalization. Materials and Methods: The present study was conducted for 1-year duration involving 110 patients diagnosed with ACS. The patients’ data pertaining to socio-demographic information, clinical features, details of hospitalization, and treatment modalities were collected. The outcomes based on mortality and major adverse cardiovascular events (MACE) were evaluated in two phases: (a) in-hospital and (b) at the 30th day from the date of hospitalization. Results: Out of 110 patients hospitalized with a diagnosis of ACS, the majority were male (71.82%), and their mean age was 58.45±9.18 years. Hypertension, obesity, smoking, and family history of ACS were reported by 40%, 30%, 30%, and 27.27% of patients, respectively. Chest pain was the commonest symptom, followed by sweating and radiating pain. The mean duration of hospitalization was 6.345±2.46 days. ST-segment elevation myocardial infarction (STEMI) was the commonest type of ACS, with a predominance of anterior wall myocardial infarction (MI). The mean door-to-needle time was 43.53±7.75 min, and 29.1% of patients underwent thrombolysis. During hospitalization, improvement and MACE were observed in 73.64% and 26.36% of patients, respectively. 30-day outcome MACE was significantly higher among STEMI patients. Mortality was significantly higher in patients with <30% left ventricular ejection fraction (LVEF), both during hospitalization and after 30 days. Conclusion: The present study revealed that the mean age of presentation was 58.45±9.18 years. Anterior wall MI was the commonest pattern of STEMI. Thus, the type of MACE and mortality were significantly higher among patients with either LVEF <30% or STEMI. Thus, type and severity of ACS, along with clinical presentation, existing risk factors, and access to medical care, play a determining role in the clinical outcome of a patient.

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Section: Discussionsupporting

confidence: 70%

Clinical profile and 30-day outcome of patients with acute coronary syndrome

Dutta,

Naruttam Sonowal,

Mech

et al. 2023

Asian J Med Sci

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“…In STEMI subgroup, anterior wall MI was more common than inferior MI similar to the study by Jose and Gupta. 19 These results, however, differed from study by Singh et al 31 where anterior and inferior MIs had similar frequency. Incidence of RBBB in ACS patients in our study was 1.4%, which is much less than 4% to 10% reported in Western studies.…”

Section: Discussionmentioning

confidence: 77%

Clinical Characteristics, Management Strategies, and In-Hospital Outcomes of Acute Coronary Syndrome in a Low Socioeconomic Status Cohort: An Observational Study From Urban India

Sidhu

Rangaiah

et al. 2020

Clin Med Insights Cardiol

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Background: Coronary artery disease is the leading cause of mortality in India. There is scarcity of data on demographic profile and outcomes of acute coronary syndrome (ACS) in low socioeconomic status (SES) population of India. Objectives: This study was undertaken to determine the clinical presentation, management strategies, and in-hospital outcomes of ACS in low SES population. Methods: We conducted 1-year prospective observational cohort study of ACS patients admitted at Employees State Insurance Corporation unit of our tertiary care cardiac center. Clinical parameters, management strategies, and in-hospital outcomes of 621 patients enrolled during the study period from February 2015 to January 2016 were studied. Results: Mean age of patients was 56.06 ± 11.29 years. Majority (62%) of the patients had ST elevation myocardial infarction (STEMI), whereas Non-ST elevation acute coronary syndrome (NSTE-ACS) was seen in 38% of the patients. Median time from symptom onset to hospital admission was 285 min with wide range from 105 to 1765 min. Coronary angiography was performed in 81% of patient population. Single-vessel disease (SVD) was the most common pattern (seen in 43.3%) of coronary artery involvement with left anterior descending coronary artery (LAD) being the most frequently involved vessel (62.8%). Pharmaco-invasive approach was the preferred strategy. Overall percutaneous coronary intervention (PCI) rates were 59.1% (62.1% in STEMI and 54.2% in NSTE-ACS). Overall in-hospital mortality was 3.2%, being significantly higher in STEMI (4.2%) as compared with NSTE-ACS (1.7%). Conclusions: With implementation of evidence-based pharmacotherapy and interventions, outcomes comparable with developed countries can be achieved even in low SES populations of developing world.

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“…The mean age of the study population was 59.3+12.8 years as compared to 60+12 years in a study by Mohanan et al 20 , 58+11 years by Sahed et al in Pakistan 21 , 51+8.80 years by Ahmed et al 22 in Bangladesh and 62+5 years in COURAGE trial 23 conducted in the USA. fifty six percent of patients were above 60 years and 14 % of patients were below 45 years and 21% were below 50 years compared to 27% in a study by Agrawal et al 24 Overall, women were older with female age of 61.75+10.85 years vs male age of 58.5+13.35 years compared to 66.41+13.1 years vs 52.49+11.7 years in a study by Singh et al 25 and 70.7+12.7 years vs 63.8+12.9 years in a study by Isorni et al 26 Among 419 patients, majority of the patients were male (75.7%) and only 24.7% were female. This is as seen in INTERHEART study 27 and its South Asian Cohort (Overall Male 76% and 85% in South Asian Male)…”

Section: Discussionmentioning

confidence: 87%

Clinical characteristics, risk factors and angiographic profile of acute coronary syndrome patients in a tertiary care center of Nepal.

Shakya¹,

Jha²,

Gajurel³

et al. 2019

Nepalese Heart J.

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Background and Aims: Acute coronary syndrome (ACS) refers to a group of clinical symptoms consistent with new onset or worsening ischemic symptoms. ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA) are the three types of ACS. The objectives were to study the risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in ACS among patients admitted in Cardiology Department of Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC). Methods: This is a restrospective study of 419 ACS patients admitted and treated in MCVTC from November 2017 to October 2018. Patients were divided into STEMI, NSTEMI and UA then analyzed for various risk factors, angiographic patterns and severity of coronary artery disease. Results: Mean age of presentation was 59.3Å}12.8 years. Majority were male 317(75.7%). Most patients had STEMI 252 (60.1%) followed by NSTEMI 98 (23.4%) and UA 69 (16.5 %). Risk factors: smoking was present in 241 (57.5%), hypertension in 212 (50.6%), diabetes in 144 (34.4%), dyslipidemia in 58 (13.8%). Single-vessel disease was present in 34.6 % patients, double- vessel disease was present in 27.44 % patients and triple vessel disease was present in 26.3 % patients, left main disease in 1.4 % patients. Normal coronaries were present in 6.4% patients and minor coronary artery disease in 3.8 % patients. Conclusions: STEMI was the most common presentation. Three quarters of ACS were male patients. Smoking was most prevalent risk factor. Single vessel involvement was the most common CAG finding in all spectrum of ACS. Diabetic patients had more multivessel disease.

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The clinical spectrum of acute coronary syndromes: A study from tertiary care centre of Kumaun region of Uttarakhand

Cited by 5 publications

References 2 publications

Clinical profile and 30-day outcome of patients with acute coronary syndrome

Clinical profile and 30-day outcome of patients with acute coronary syndrome

Clinical Characteristics, Management Strategies, and In-Hospital Outcomes of Acute Coronary Syndrome in a Low Socioeconomic Status Cohort: An Observational Study From Urban India

Clinical characteristics, risk factors and angiographic profile of acute coronary syndrome patients in a tertiary care center of Nepal.

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