Document Type : Original Article
Department of Cardiology, Ain Shams University, Cairo, Egypt.
Background: Acute coronary syndrome (ACS) is a type of coronary heart disease responsible for one-third of deaths in individuals older than 35. Registries are a powerful tool to improve patient care and research.
Methods: We registered 1432 patients with ACS from 2 major tertiary healthcare institutes in Cairo from August 2019 through July 2020. ST-elevation myocardial infarction (STEMI) was reported in 50.6% of the patients, non–ST-elevation myocardial infarction (NSTEMI) in 28.9%, and unstable angina in 20.5%.
Results: The mean age was 66.9 ± 11.3 years, 78.4% were male, and 56.4% were current smokers. The most frequent comorbidities were hypertension (52.2%) and diabetes mellitus (47.3%). A history of ischemic heart disease was reported in 24.2%. Both institutes are 24/7 primary percutaneous coronary intervention (PCI)-capable centers; consequently, primary PCI for STEMI patients and invasive strategies for non–ST-elevation ACS patients were done once indicated. Drug-eluting stents were used in 69.7% and bare-metal stents in 30.3% of the patients undergoing primary PCI. The rates of in-hospital major adverse cardiovascular events (MACE) and mortality were 4.8% and 0.8%, respectively. In-hospital and discharge medications were optimal. The potential of different factors as predictors of in-hospital MACE was evaluated using multivariate and univariate analyses. In-hospital MACE occurrence was more frequent in STEMI patients. The multivariate analysis showed that MACE occurred more frequently in STEMI patients with chronic kidney disease, ischemic cardiomyopathy, peripheral arterial disease, a longer door-to-balloon time, and multivessel disease.
Conclusions: This registry is one of the largest ACS registries in Cairo, Egypt, covering patient characteristics, risk factors, interventional methods, and medical treatment. (Iranian Heart Journal 2023; 24(3): 32-44)