| ORIGINAL ARTICLE |
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| Year : 2021 | Volume
: 10
| Issue : 2 | Page : 23-32 |
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Clinical characteristics, management, and 1-year outcomes of patients with acute coronary syndrome admitted to a tertiary health-care center of Kerala: A prospective study
Suneesh Kalliath1, Rajesh Gopalan Nair1, Haridasan Vellani1, Sajeev Govindan Chakanalil1, Kader Muneer1, Vinayakumar Deshabandu1, Dolly Mathew1, Biju George2
1 Department of Cardiology, Government Medical College, Kozhikode, India
2 Professor of Social and Preventive Medicine, Government Medical College Kozhikode, Kerala, India
Correspondence Address:
Dr. Suneesh Kalliath
Department of Cardiology, Government Medical College, Kozhikode 673008, Kerala.
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/khj.khj_7_21
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Background: There are limited data on the late outcome of the acute coronary syndrome (ACS) in India. We prospectively investigated the clinical characteristics, management, and 1-year outcomes of patients with ACS admitted to a tertiary care center of South India. Materials and Methods: In this prospective observational study, we enrolled 3149 adults hospitalized with a diagnosis of ACS between December 1, 2014 and March 31, 2017 at Government Medical College Kozhikode, Kerala. Patients were followed up at 30 days, 6 months, and 1 year. Primary outcome was all-cause mortality at 365 days. Secondary outcomes were 30-day mortality, sudden cardiac death (SCD), and major adverse cardiac events (MACEs) at 1 year after discharge. Results: A total of 3149 patients with ACS were admitted during the study period (48% with ST-elevation myocardial infarction [STEMI], 37% with non-ST-elevation MI [NSTEMI], and 15% unstable angina [UA]). The patients were of ages 58 ± 11.9 years. During hospitalization, the majority of the patients received guideline recommended drugs and percutaneous coronary intervention (PCI) was performed in 28%. Reperfusion therapy was performed in 88% of patients with STEMI (53% thrombolytic therapy and 45% including primary and rescue PCI). At 1 year, all-cause mortality and composite MACE after discharge were 14.4% and 17.6%, respectively. MACE included cardiovascular death (5.4%), re-infarction (15.7%), and non-fatal stroke (0.6%) after discharge. SCD at 1 year was 1.8%. The main factors associated with 1-year all-cause mortality and MACE were older age, prior history of ACS, ventricular tachycardia or ventricular fibrillation, right bundle branch block with Q wave, and left ventricular systolic dysfunction. Conclusion: One-year all-cause mortality after the admission of ACS was high, but post-discharge cardiovascular mortality was comparable to other developed countries. This highlights a better secondary prevention practices and risk stratification in our population. |
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