CLINICAL CHARACTERISTICS AND MORTALITY RATE IN PATIENTS HOSPITALIZED DUE TO ACUTE CORONARY SYNDROME DURING ONE YEAR AT A SINGLE CORONARY CARE UNIT

Abstract

Acute coronary syndrome (ACS) is the leading cause for coronary care unit admissions. It ranges from non-STelevation acute coronary syndrome (NSTEACS) including non-ST-elevation myocardial infarction and unstable
angina to acute ST-segment elevation myocardial infarction (STEMI) . Our aim was to study the clinical picture,
management and outcome of ACS patients admitted to the coronary care unit (CCU) at a tertiary heart centre in
Tripoli-Libya. A retrospective study was performed on the spectrum of ACS in subjects admitted to the CCU in
Tajoura National Heart Center from January 2014 to December 2014. Details including coronary risk factors, categories and outcomes were analyzed. A total of 84 patients were included in the study, the majority 64 (76.2%) were
males. their mean age was 58± 14 years, 22(26.1%) were < 50 years, and the most common age group was from 50
to 59 years. The majority 60 (71.4%) had STEMI and 24 (28.6%) had NSTEACS. The major coronary disease risk
factors were; diabetes 38 (45.2%), hypertension 38 (33.3%), history of ischemic heart disease 18 (21.4%), chronic
kidney disease (CKD) 15 (17.9%) and smoking 41 (48.8%). According to GRACE score, 13 (15.5%) were categorized as high risk, 13 (15.5%) intermediate risk and 56 (66.7%) low risk. 30 patients (35.7%) received thrombolytic
therapy, 33 (39.3%)underwent percutaneous Coronary intervention (PCI), 6 patients (7.1%) received both forms of
therapy. The mean duration of CCU stay was 4.26 ± 5 days. 11 (13.1%) patients died in the CCU including 6 (10%)
with STEMI and 5 (20.8%) with NSTEACS, their. The mortality was more among the older patients (mean age was
68.45 years ± 14.6) (P.008) and the likelihood ratio of death was more in; females (2.9), CKD patients (2.5), high
grace score (10.45) (P .008) and in patients who did not undergo PCI (12) (P.004). In this study, the ACS patients
were of relatively younger age, higher prevalence of diabetes and higher GRACE risk score. Compared with the
European centers; PCI was less (almost half) performed and fibrinolytic therapy was more used in STEMI, and PCI
was less performed in NSTEACS. The CCU mortality was high and further studies are needed to evaluate it’s the
underlying reasons.