FREQUENCY OF ACUTE HEART FAILURE IN NON ST ELEVATION ACUTE CORONARY SYNDROME; CAN WE PREDICT THE HEART FAILURE ON CLINICAL AND ELECTROCARDIOGRAPHY (ECG) BASIS?

Abstract

Objectives: Non-ST elevation acute coronary syndrome (NSTE-ACS) comprises NSTE myocardial infarction (NSTEMI) and unstable angina. A common complexity of NSTE-ACS is heart failure (HF). The objective of this study was to assess the incidence of in-hospital HF in NSTE-ACS patients and to link clinical and electrocardiographic (ECG) abnormalities to HF.

Methodology: This study was performed at National Institute of Cardiovascular Diseases (NICVD) Karachi, from January 1, 2018 to June 30, 2018. The study included all adult patients who were hospitalized with a diagnosis of non-ST elevation ACS. Their socio demographic profile, clinical findings, ECG findings, and occurrence of heart failure during hospital stay was recorded. Data was entered and analyzed using SPSS v.23.

Results: In this study 265 patients with NSTE-ACS were included. Mean age of 55.39±10.40 years was observed. There were 195 (73.6%) male patients. T-wave inversion was observed in 73 (27.5%) patients, ST-segment depression in 77 (29.1%), and both T-wave inversion and ST-segment depression in 71 (26.8%) patients. During their stay in the hospital, 28 patients (10.6 percent) developed HF. Diabetes, hypertension, smoking, a genetic susceptibility of ischemic heart disease, and combination of T-wave inversion and ST-segment depression on ECG was significantly correlated with HF (P≤0.05).

Conclusion: The determinants of HF were diabetes, hypertension, smoking, family history of ischemic heart disease, and combination of T-wave inversion and ST depression on ECG.