Acute Coronary Syndrome in an Intensive Care Unit of a Tertiary Referral Centre in Central Nepal: The Spectrum and Coronary Risk Factors.

  • Mani Prasad Gautam College of Medical Sciences, Bharatpur, Nepal
  • Guruprasad Sogunuru Department of Cardiology
  • Gangapatnam Subramanyam College of Medical Sciences, Bharatpur, Nepal
  • Lekhjung Thapa College of Medical Sciences, Bharatpur, Nepal
  • Raju Paudel College of Medical Sciences
  • Madhav Ghimire College of Medical sciences, Bharatpur, Nepal
  • Gautam Samir College of Medical Sciences, Bharatpur, Nepal
  • Usha Ghimire COMAT
  • Ramila Shilpakar College of Medical Sciences, Bharatpur, Nepal

Abstract

Introduction: Acute coronary syndrome is the major leading cause for coronary care unit admission. Its spectrum comprises a variety of disorders including unstable angina, non ST elevation and ST elevation myocardial infarction.

Methods: An observational study was designed to study the spectrum of acute coronary syndrome and associated coronary heart disease risk factors in subjects admitted in intensive care unit from August 2009 to September 2010. Details including coronary risk factors and the categories and outcomes of acute coronary syndrome were analyzed.

Results: A total of 57 subjects were included in the study. The majority (63.1%) were males. The mean age was 64.54±13.8 years.  Five (8.8%) patients were ≤45 years and 29 (50.88%) patients were ≥65 years. Majority of the patients were smokers (50.87%). The other major coronary heart disease risk factors were diabetes (43.85%), hypertension (36.87%), dyslipidemia (26.32%) and previous history of coronary heart disease (31.58%). Coronary heart disease figured prominently in the family history as well (26.32%). ST elevation myocardial infarction was the major category (42.11%) followed by non-ST elevation myocardial infarction and unstable angina (31.58% and 26.32% respectively). Myocardial infarction complicated with cardiogenic shock had very high mortality (83.33%).  

Conclusions: The ST elevation myocardial infarction was the major clinical form of acute coronary syndrome admitted in intensive care unit. Prevention should be targeted on modifiable risk factors such as the management of risk factors. In addition, the improvement in cardiology service with the establishment of CCU and cathlab might alter the mortality and morbidity in ACS management.

Keywords: acute coronary syndrome; coronary risk factors; intensive care unit.

Author Biographies

Mani Prasad Gautam, College of Medical Sciences, Bharatpur, Nepal
Department of Cardiology
Guruprasad Sogunuru, Department of Cardiology
Associate Professor, Department of Cardiology
Gangapatnam Subramanyam, College of Medical Sciences, Bharatpur, Nepal
Professor, Department of Cardiology
Lekhjung Thapa, College of Medical Sciences, Bharatpur, Nepal
Department of Neurology
Raju Paudel, College of Medical Sciences
Department of Neurology
Madhav Ghimire, College of Medical sciences, Bharatpur, Nepal
Department of Nephrology
Gautam Samir, College of Medical Sciences, Bharatpur, Nepal
DM Cardiology Residents
Usha Ghimire, COMAT
Consultant
Ramila Shilpakar, College of Medical Sciences, Bharatpur, Nepal
MD Resident

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Published
2013-06-30
How to Cite
Gautam, M., Sogunuru, G., Subramanyam, G., Thapa, L., Paudel, R., Ghimire, M., Samir, G., Ghimire, U., & Shilpakar, R. (2013). Acute Coronary Syndrome in an Intensive Care Unit of a Tertiary Referral Centre in Central Nepal: The Spectrum and Coronary Risk Factors. Journal of Nepal Medical Association, 52(190). https://doi.org/10.31729/jnma.1897
Section
Original Article