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Indian Heart J ; 66(2): 156-63, 2014.
Article in English | MEDLINE | ID: mdl-24814108

ABSTRACT

BACKGROUND: Coronary artery disease (CAD) is a major cause of death in India. Data on outcome of CAD is scarce in the Indian population. This study determined the characteristics, treatment and one-year outcomes of acute coronary syndrome (ACS) in an Indian Cardiac Centre. METHODS: We carried out a cross sectional retrospective analysis of 1468 ACS patients hospitalized between January 2008 and December 2010 and followed up for 1 year in the Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai. Mortality at 1 year, its determinants and 1 year major adverse cardiac events (MACE) were determined. RESULTS: The patients were aged 62.2 ± 11.2 years; males (75.2%) and had ST segment elevation myocardial infarction (STEMI) (33.9%), non ST segment elevation myocardial infarction (44.2%) and unstable angina (21.9%). Key pharmacotherapy included aspirin (98.2%), clopidogrel (95.1%), statins (95.6%), angiotensin converting enzyme inhibitor/angiotensin receptor blocker (50.6%) and beta blocker (83.1%). Angiography rate was 80.6%. In the STEMI group, 53.3% had primary angioplasty, 20.3% were thrombolysed and 16.1% received sole medical therapy. Overall coronary artery bypass graft rate was 12.4%. At one year, all-cause mortality and composite MACE were 2.5% and 9.7%, respectively. MACE included death (2.5%), reinfarction (4.0%), resuscitated cardiac arrest (1.8%), stroke (1.1%) and bleeding (0.4%). Main factors associated with mortality were combined left ventricular systolic and diastolic dysfunction (OR = 20.0, 95% CI = 6.63-69.4) and positive troponin I (OR = 12.56, 95% CI = 1.78-25.23). Troponin I independently predicted mortality. CONCLUSIONS: ACS population was older than previously described in India. Evidence-based pharmacotherapy and interventions, and outcomes were comparable to the developed nations.


Subject(s)
Acute Coronary Syndrome/mortality , Acute Coronary Syndrome/therapy , Angioplasty, Balloon, Coronary/methods , Cause of Death , Myocardial Infarction/mortality , Thrombolytic Therapy/methods , Acute Coronary Syndrome/diagnosis , Age Factors , Aged , Angioplasty, Balloon, Coronary/mortality , Confidence Intervals , Coronary Angiography/methods , Cross-Sectional Studies , Electrocardiography/methods , Female , Follow-Up Studies , Humans , India , Male , Middle Aged , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/therapy , Odds Ratio , Retrospective Studies , Risk Assessment , Sex Factors , Survival Analysis , Tertiary Care Centers , Thrombolytic Therapy/mortality , Time Factors , Treatment Outcome
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