ACUTE CORONARY SYNDROME: AN EXPERIENCE AT LADY READING HOSPITAL PESHAWAR

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Mohammad Irfan, Shah Zeb, Mohammad Hafizullah, Hikmatullah Jan, Junaid Zeb

Abstract

Objective: To know the clinical characteristics, treatment given and in hospitaloutcome of the patients admitted to Cardiology Unit LRH with acute coronarysyndrome.


Methodology: This cross sectional study was conducted from 1 January to31 December 2013 in Cardiology Unit Lady Reading Hospital Peshawar. All thepatients admitted with suspected coronary artery disease were included in thestudy. Risk factors (smoking, hypertension, and diabetes mellitus), infarctterritory (anterior, inferior and combination), rhythm disturbances (sinus vs.atrio-ventricular block), treatment offered and in hospital outcome weredocumented. Data was analyzed by SPSS version 17.


Results: Total number of patients admitted with acute coronary syndrome was2033.Of them, NSTEMI (Troponin T positive) were 24%. Of all the patients withNSTEMI, males were 53.20%, Mean age was 62.43±7.8 years. Diabetes wasdocumented in 37.47%, hypertension in 42.4%, family history of coronary arterydisease (CAD) was present in 13.2%, past history of CAD was present in 24.84%of patients while smokers were 12.62%. New onset AF was found in 8.07% ofpatients. Unstable angina was documented in 76% of ACS patients with meanage of 61.12 ± 9.3 years. About 32.12% were diabetics , 38.32% werehypertensive , smokers 11.87%, positive family history of CAD in 11.80% whilepast history of CAD was present in 19.48% of patients. Acute pulmonary edemaoccurred in 10.5% patients, cardiogenic shock in 5.17% and ventriculararrhythmia occurred in 8.4% of NSTEMI patients while acute pulmonary edema,cardiogenic shock and ventricular arrhythmia occurred in1.3%, 0.7% and 2.9%respectively of unstable angina patients. In hospital mortality was 4.7 % inNSTEMI and 1.9% in unstable angina patients.


Conclusion: More than one third of the patients admitted with acute coronarysyndrome had diabetes mellitus. New onset AF, ventricular arrhythmias andmortality was higher in the NSTEMI group than in the unstable angina.

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