ACUTE CORONARY SYNDROME: AN EXPERIENCE AT LADY READING HOSPITAL PESHAWAR

Objective: To know the clinical characteristics, treatment given and in hospital outcome of the patients admitted to Cardiology Unit LRH with acute coronary syndrome. Methodology: This cross sectional study was conducted from 1st January to 31st December 2013 in Cardiology Unit Lady Reading Hospital Peshawar. All the patients admitted with suspected coronary artery disease were included in the study. Risk factors (smoking, hypertension, and diabetes mellitus), infarct territory (anterior, inferior and combination), rhythm disturbances (sinus vs. atrio-ventricular block), treatment offered and in hospital outcome were documented. Data was analyzed by SPSS version 17. Results: Total number of patients admitted with acute coronary syndrome was 2033.Of them, NSTEMI (Troponin T positive) were 24%. Of all the patients with NSTEMI, males were 53.20%, Mean age was 62.43 +/- 7.8 years. Diabetes was documented in 37.47%, hypertension in 42.4%, family history of coronary artery disease (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% of patients. Unstable angina was documented in 76% of ACS patients with mean age of 61.12 +/- 9.3 years. About 32.12% were diabetics, 38.32% were hypertensive, smokers 11.87%, positive family history of CAD in 11.80% while past history of CAD was present in 19.48% of patients. Acute pulmonary edema occurred in 10.5% patients, cardiogenic shock in 5.17% and ventricular arrhythmia 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 % in NSTEMI and 1.9% in unstable angina patients. Conclusion: More than one third of the patients admitted with acute coronary syndrome had diabetes mellitus. New onset AF, ventricular arrhythmias and mortality was higher in the NSTEMI group than in the unstable angina.