A Clinical Registry Study on Acute Coronary Syndrome Patients in Cairo

Document Type : Original Article

Authors

Department of Cardiology, Ain Shams University, Cairo, Egypt.

Abstract

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)

Keywords

References

  1. Turpie, Alexander GG. "Burden of disease: medical and economic impact of acute coronary syndromes." American Journal of Managed Care 12, no. 16 (2006): S430.
  2. Allport, Shannon Anjelica, Ngum Kikah, Nessim Abu Saif, Fonkem Ekokobe, and Folefac D. Atem. "Parental age of onset of cardiovascular disease as a predictor for offspring age of onset of cardiovascular disease." PloS one 11, no. 12 (2016): e0163334.
  3. Bentzon, Jacob Fog, Fumiyuki Otsuka, Renu Virmani, and Erling Falk. "Mechanisms of plaque formation and rupture." Circulation research 114, no. 12 (2014): 1852-1866.
  4. Gliklich, R. E., N. A. Dreyer, and M. B. Leavy. "Registries for evaluating patient outcomes: a user’s guide (no. 13)." Washington, DC: Government Printing Office (2014).
  5. Shaheen, Sameh, Ahmad Wafa, Mostafa Mokarab, Basem Zareef, Ahmed Bendary et al. "Presentation, management, and outcomes of STEMI in Egypt: results from the European Society of Cardiology Registry on ST elevation myocardial infarction." The Egyptian Heart Journal 72, no. 1 (2020): 1-10.
  6. Thygesen, Kristian, Joseph S. Alpert, Harvey D. White, and Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. "Universal definition of myocardial infarction." Journal of the American College of Cardiology 50, no. 22 (2007): 2173-2195.
  7. Kang, Si-Hyuck, Jung-Won Suh, Chang-Hwan Yoon, Myeong Chan Cho, Young Jo Kim et al. "Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean Acute Myocardial Infarction National Registry)." The American journal of cardiology 109, no. 6 (2012): 787-793.
  8. Van’t Hof, Arnoud WJ. "Successful reperfusion therapy: from epicardial to myocardial salvage." Revista Española de Cardiología (English Edition) 7, no. 63 (2010): 757-759.
  9. Killip III, Thomas, and John T. Kimball. "Treatment of myocardial infarction in a coronary care unit: a two year experience with 250 patients." The American journal of cardiology 20, no. 4 (1967): 457-464.
  10. Roffi, M., C. Patrono, J. P. Collet, C. Mueller, M. Valgimigli, F. Andreotti et al. "Management of Acute Coronary Syndromes in Patients Presenting without Persistent STSEotESoC. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)." Eur Heart J 37, no. 3 (2016): 267-315.
  11. Samad, Zainab, Abdul Hakeem, Syed Shad Mahmood, Karen Pieper, Manesh R. Patel et al. "A meta-analysis and systematic review of computed tomography angiography as a diagnostic triage tool for patients with chest pain presenting to the emergency department." Journal of Nuclear Cardiology 19, no. 2 (2012): 364-376.
  12. Granger, Christopher B., Robert J. Goldberg, Omar Dabbous, Karen S. Pieper, Kim A. Eagle et al. "Predictors of hospital mortality in the global registry of acute coronary events." Archives of internal medicine 163, no. 19 (2003): 2345-2353.
  13. Palmerini, Tullio, Philippe Genereux, Adriano Caixeta, Ecaterina Cristea, Alexandra Lansky, Roxana Mehran et al. "Prognostic value of the SYNTAX score in patients with acute coronary syndromes undergoing percutaneous coronary intervention: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial." Journal of the American College of Cardiology 57, no. 24 (2011): 2389-2397.
  14. Ragy, Hany I., Ghada A. Kazamel, Mohamed Sleem, Khaled El Tohamy, Mohamed Helmy et al. "Acute coronary syndrome registry." Life Sci J 14 (2017): 39-44.
  15. Abdelmoneim, Haitham M., Hosam Hasan-Ali, and Samir S. Abdulkader. "Demographics of acute coronary syndrome (ACS) Egyptian patients admitted to Assiut University Hospital: Validation of TIMI and GRACE scores." The Egyptian Journal of Critical Care Medicine 2, no. 1 (2014): 3-11.
  16. Bashandy, Mohamed S., Heba M. Abd Elgalil, and Hanaa AE Abou Elhassan. "Epidemiological and clinical profile of acute coronary syndrome of Egyptian patients admitted to the Coronary Care Unit, Al-Azhar University Hospital, New Damietta." The Scientific Journal of Al-Azhar Medical Faculty, Girls 3, no. 3 (2019): 625.
  17. Yusufali, Afzalhussein M., Wael AlMahmeed, Sadeq Tabatabai, Kabad Rao, and Azan Binbrek. "Acute coronary syndrome registry from four large centres in United Arab Emirates (UAE-ACS Registry)." Heart Asia 2, no. 1 (2010): 118-121.
  18. AlHabib, Khalid F., Ahmad Hersi, Hussam AlFaleh, Mohammad Kurdi, Mohammad Arafah et al. "The Saudi Project for Assessment of Coronary Events (SPACE) registry: design and results of a phase I pilot study." Canadian Journal of Cardiology 25, no. 7 (2009): e255-e258.
  19. Zubaid, Mohammad, Khalid Bin Thani, Wafa Rashed, Alawi Alsheikh-Ali, Najib Alrawahi et al. "Design and rationale of gulf locals with acute coronary syndrome events (Gulf Coast) registry." The open cardiovascular medicine journal 8 (2014): 88.
  20. Mohanan, Padinhare Purayil, Rony Mathew, Sadasivan Harikrishnan, Mangalath Narayanan Krishnan, Geevar Zachariah et al. "Presentation, management, and outcomes of 25 748 acute coronary syndrome admissions in Kerala, India: results from the Kerala ACS Registry." European heart journal 34, no. 2 (2013): 121-129.
Iranian Heart Journal
Volume 24, Issue 3
July 2023
Pages 32-44

Files

Share

How to cite

Statistics