Multicenter HP ACS Registry
Prakash Chand Negi1, Rajeev Merwaha2, Deveshwar Panday3
1Professor, Cardiology, IGMC Shimla, HP, India.
Insights
This study reveals prolonged pre-hospital delay and low reperfusion rates in acute coronary syndrome (ACS) patients, leading to higher in-hospital mortality. Improving emergency response is crucial for ACS patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Clinical Research
Background:
- Limited population-representative data on acute coronary syndrome (ACS) patient characteristics, treatment, and outcomes.
- Need for comprehensive data to inform clinical practice and public health strategies for ACS.
Purpose of the Study:
- To report on the clinical characteristics, treatment, and in-hospital outcomes of a large cohort of ACS patients.
- To identify factors contributing to adverse outcomes in ACS.
Main Methods:
- Analysis of data from 5180 ACS patients registered in a multicenter ACS Registry (2012-2014).
- Standard diagnostic criteria used for ACS.
- Evaluation of pre-hospital delay, reperfusion therapy, evidence-based treatment, and in-hospital mortality.
Main Results:
- Majority of patients were male (70.8%), with a mean age of 60.9 years.
- Non-ST-elevation myocardial infarction (NSTEMI) was more common than ST-elevation myocardial infarction (STEMI).
- Long pre-hospital delay (median 780 min) and lower use of reperfusion therapy were observed, particularly in STEMI patients.
- In-hospital mortality was 7.6%, significantly higher in STEMI (10.8%) than NSTEMI (5.0%).
Conclusions:
- Significant pre-hospital delays and suboptimal reperfusion therapy use impact ACS patient outcomes.
- Higher in-hospital mortality rates underscore the need for improved emergency medical services and timely interventions for ACS.
- Evidence-based treatments were widely used, but outcomes suggest challenges in acute management and transport.
Background:
No population representative data on characteristics, treatment, and outcome were available in acute coronary syndrome (ACS) patients.
Methods:
The clinical characteristics, treatment, and in-hospital outcome of 5180 ACS patients registered in multicenter ACS Registry across 33 hospitals in the state since January 2012 to December 2014 are reported. ACS was diagnosed using standard criteria.
Result:
70.8% were men; mean age was 60.9±12.1. NSTEMI was more frequent than STEMI (54.5% vs. 45.5%). 83.3% of the ACS population were from rural area. Pre-hospital delay was long, with a median of 780min. 35.6% of STEMI patients received thrombolytic therapy. Evidence-based treatment was prescribed in more than 80% of ACS patients, and the treatment was similar in men and women across all types of health care centers. In-hospital mortality was 7.6%, and was more frequent in STEMI than in NSTEMI (10.8% vs. 5.0%, p<0.001).
Interpretation:
Pre-hospital delay was long, and use of reperfusion therapy was significantly lower. The in-hospital death rates are higher.
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