Clinical presentation and outcome in patients presenting with acute coronary syndrome - A prospective study

Background: Acute chest pain is one of the most common reasons for seeking care in the emergency department. Acute coronary syndrome (ACS) is a spectrum of diseases comprising unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI). The present study was undertaken to study the clinical presentation and outcomes of patients with ACS. Methods: In this prospective observational study conducted in a tertiary care teaching hospital in Tirupati, during the period February 2015 to June 2016, demographic, clinical profile, treatment modalities and outcome in patients with ACS were studied. Results: A total of 1034 patients with ACS presented to the emergency room, during the study period. Mean age of the study population was 56.7 ± 11.7 years. STEMI accounted for 67% of the cases. Three hundred and forty one patients (33%) presented with NSTEMI (n = 256) and UA (n = 85). In 823 patients with ACS (79.6%), percutaneous coronary intervention (PCI) with stenting was done, and among those, primary PCI was done in 196 cases. Mean duration of stay in the hospital was 4.86 ± 1.5 days. Thirty-seven cases (3.9%) expired during the follow-up period. Reinfarction in minority cases (0.8%). Conclusions: In the present study, ACS is more common in the younger age group with male predominance. Majority of the patients presented with Killip Class I. Most of the patients underwent PCI.