title: Acute coronary syndrome in an intensive care unit of a tertiary care centre: the spectrum and coronary risk factors.
abstract: BACKGROUND
  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. Its spectrum and incidence is crucial as a part of need assessment of cardiac catheterization laboratories.
  
  
  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 of College of Medical Sciences Teaching Hospital, Bharatpur, Nepal 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 36 (63.16%) 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. The major coronary heart disease risk factors were smoking 29 (50.88%), diabetes 25 (43.85%), hypertension 21 (36.87%), and previous history of coronary heart disease 18 (31.58%). ST elevation myocardial infarction was the major category 24 (42.11%) followed by non-ST elevation myocardial infarction and unstable angina 18 (31.58%) and 15 (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 modiﬁ able risk factors such as the management of hypertension, dyslipidemia, diabetes and obesity. In addition, the improvement in cardiology service with the establishment of CCU and cathlab might improve the mortality and morbidity in such cases.
authors.affiliation: Department of Cardiology, College of Medical Sciences, Bharatpur, Nepal.
authors.forename: Mani Prasad
authors.initials: MP
authors.lastname: Gautam
authors.affiliation: Department of Cardiology, College of Medical Sciences, Bharatpur, Nepal.
authors.forename: Guruprasad
authors.initials: G
authors.lastname: Sogunuru
authors.affiliation: Department of Cardiology, College of Medical Sciences, Bharatpur, Nepal.
authors.forename: Gangapatnam
authors.initials: G
authors.lastname: Subramanyam
authors.affiliation: Department of Neurology, College of Medical Sciences, Bharatpur, Nepal.
authors.forename: Lekh Jung
authors.initials: LJ
authors.lastname: Thapa
authors.affiliation: Department of Nephrology, College of Medical Sciences, Bharatpur, Nepal.
authors.forename: Raju
authors.initials: R
authors.lastname: Paudel
authors.affiliation: Department of Nephrology, College of Medical Sciences, Bharatpur, Nepal.
authors.forename: Madhav
authors.initials: M
authors.lastname: Ghimire
authors.affiliation: Department of Cardiology, College of Medical Sciences, Bharatpur, Nepal.
authors.forename: Samir
authors.initials: S
authors.lastname: Gautam
authors.affiliation: COMAT, Kathmandu, Nepal.
authors.forename: Usha
authors.initials: U
authors.lastname: Ghimire
authors.affiliation: Department of Medicine, College of Medical Sciences, Bharatpur, Nepal.
authors.forename: Ramira
authors.initials: R
authors.lastname: Silpakar
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000368:Aged; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009390:Nepal / Q000453:epidemiology; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology