Clinical profile and outcomes of patients presenting with acute coronary syndrome in a tertiary care hospital

Abstract

Objective: This article aimed to study the clinical profile and outcomes of patients presenting with acute coronary syndrome at a tertiary care hospital and to draw conclusions from the above data with regard to characteristics of Indian patients presenting with acute coronary syndrome. Materials and Methods: This cross-sectional study was carried out in one of the teaching medical college hospitals. All patients presenting to casualty with an acute coronary syndrome were admitted to the Coronary Care Unit. Standard history was taken, data were entered into a pro forma sheet, and relevant investigations were performed. Patients with ST-segment elevation myocardial infarction were thrombolysed, taken up for percutaneous transluminal coronary angioplasty (PTCA), or managed conservatively. Prompt medical treatment was started in all cases. The hospital course of the patients including complications, if any, was documented. Results and Conclusion: A total of 100 patients presenting with the acute coronary syndrome were studied. The majority of the patients were found to be male (77%). Hypertension was the most common risk factor followed by smoking, diabetes mellitus, and dyslipidemia. Of all patients, 63% presented with myocardial infarction. Serious complications occurred in 23% patients. The mean age of all patients was 55.5 ± 12.1 years. The age of presentation of females was on average a decade more than that of males. A small but significant percentage (11%) included premature patients younger than 40 years. Most of the patients presented between 1 and 6h of symptom onset. Of all patients, 33% underwent successful PTCA and were discharged on appropriate medication; moreover, 25% were advised PTCA but did not undergo due to various reasons. These were then managed medically. Of all patients, 15% were advised coronary artery bypass grafting and 24% were put on aggressive medical management. A majority of patients presented with single-vessel coronary artery disease (44%) and 3% died during the index hospitalization.