Kerala Heart Journal

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 10  |  Issue : 2  |  Page : 23--32

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

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.


How to cite this article:
Kalliath S, Nair RG, Vellani H, Chakanalil SG, Muneer K, Deshabandu V, Mathew D, George B. 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.KERALA HEART J 2021;10:23-32


How to cite this URL:
Kalliath S, Nair RG, Vellani H, Chakanalil SG, Muneer K, Deshabandu V, Mathew D, George B. 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. KERALA HEART J [serial online] 2021 [cited 2022 Nov 29 ];10:23-32
Available from: http://www.csikhj.com/article.asp?issn=2347-5267;year=2021;volume=10;issue=2;spage=23;epage=32;aulast=Kalliath;type=0