J Med Assoc Thai 2015; 98 (11):96

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Demographics, Management Practices and In-Hospital Outcomes: Results from the HRH Princess Maha Chakri Sirindhorn Medical Center Acute Coronary Syndrome Registry
Roongsangmanoon W Mail, Suanklay K , Angkananard T

Objective: To determine the demographics and in-hospital outcomes of patients with acute coronary syndrome. It provides a real-life data to assess treatment strategies for acute coronary syndrome (ACS) patients.
Material and Method: The prospective study included patients who were hospitalized with the diagnosis of ACS during January to December, 2013. The data were analyzed in terms of characteristics, clinical presentation, treatment, and inhospital
outcomes.
Results: A total of 105 patients were enrolled. Mean age of all patients was 73.8 years and half of the patients were older than
70 years old. Twenty patients were classified as ST-segment elevation myocardial infarction (STEMI) and 85 as unstable
angina or non-ST-segment elevation myocardial infarction (UA/NSTEMI). Overall prevalence of diabetes was 52.4%. The
STEMI group was predominantly male, with a fewer number of diabetes than in UA/NSTEMI group. Eighty percent of the STEMI patients received reperfusion therapy. Primary percutaneous coronary intervention (PCI) was performed in 70% of STEMI patients. The median door-to-needle and door-to-balloon time were 60 and 74 minutes, respectively. Six of fourteen primary PCI patients received it after 90 minutes. Nearly half of UA/NSTEMI patients went to coronary angiography and about one-third of them received revascularization with either PCI or coronary artery bypass grafting. The total mortality rate was 15% in both the STEMI patients and the UA/NSTEMI patients.
Conclusion: This registry provided a detail of demographics, management practices, and in hospital outcomes of ACS
patients. Door-to-needle time and door-to-balloon time were considered as suboptimal. In-hospital mortality was higher than
the latest national average. Patient delay should be improved by giving more education to the general public and concerted effort to improve in-hospital time delay is warranted. These data have an impact on our patient care system and alert our team to improve patient care.

Keywords: Acute coronary syndrome, ST-segment elevation myocardial infarction, Non-ST-segment elevation myocardial
infarction, Unstable angina, Registry


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