title: Characteristics, treatment and one-year outcomes of patients with acute coronary syndrome in a tertiary hospital in India.
abstract: BACKGROUND
  Coronary artery disease (CAD) is a major cause of death in India. Data on outcome of CAD is scarce in the Indian population. This study determined the characteristics, treatment and one-year outcomes of acute coronary syndrome (ACS) in an Indian Cardiac Centre.
  
  
  METHODS
  We carried out a cross sectional retrospective analysis of 1468 ACS patients hospitalized between January 2008 and December 2010 and followed up for 1 year in the Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai. Mortality at 1 year, its determinants and 1 year major adverse cardiac events (MACE) were determined.
  
  
  RESULTS
  The patients were aged 62.2 ± 11.2 years; males (75.2%) and had ST segment elevation myocardial infarction (STEMI) (33.9%), non ST segment elevation myocardial infarction (44.2%) and unstable angina (21.9%). Key pharmacotherapy included aspirin (98.2%), clopidogrel (95.1%), statins (95.6%), angiotensin converting enzyme inhibitor/angiotensin receptor blocker (50.6%) and beta blocker (83.1%). Angiography rate was 80.6%. In the STEMI group, 53.3% had primary angioplasty, 20.3% were thrombolysed and 16.1% received sole medical therapy. Overall coronary artery bypass graft rate was 12.4%. At one year, all-cause mortality and composite MACE were 2.5% and 9.7%, respectively. MACE included death (2.5%), reinfarction (4.0%), resuscitated cardiac arrest (1.8%), stroke (1.1%) and bleeding (0.4%). Main factors associated with mortality were combined left ventricular systolic and diastolic dysfunction (OR = 20.0, 95% CI = 6.63-69.4) and positive troponin I (OR = 12.56, 95% CI = 1.78-25.23). Troponin I independently predicted mortality.
  
  
  CONCLUSIONS
  ACS population was older than previously described in India. Evidence-based pharmacotherapy and interventions, and outcomes were comparable to the developed nations.
authors.affiliation: Professor, Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Electronic address: simeonisezuo@yahoo.com.
authors.forename: Simeon
authors.initials: S
authors.lastname: Isezuo
authors.affiliation: Institute of Cardiovascular Disease, Madras Medical Mission, Chennai, India.
authors.forename: Vijayakumar
authors.initials: V
authors.lastname: Subban
authors.affiliation: Institute of Cardiovascular Disease, Madras Medical Mission, Chennai, India.
authors.forename: Jaishankar
authors.initials: J
authors.lastname: Krishnamoorthy
authors.affiliation: Institute of Cardiovascular Disease, Madras Medical Mission, Chennai, India.
authors.forename: Ulhas Madhukarrao
authors.initials: UM
authors.lastname: Pandurangi
authors.affiliation: Institute of Cardiovascular Disease, Madras Medical Mission, Chennai, India.
authors.forename: Ezhilan
authors.initials: E
authors.lastname: Janakiraman
authors.affiliation: Institute of Cardiovascular Disease, Madras Medical Mission, Chennai, India.
authors.forename: Latchumanadhas
authors.initials: L
authors.lastname: Kalidoss
authors.affiliation: Institute of Cardiovascular Disease, Madras Medical Mission, Chennai, India.
authors.forename: Mullasari Ajit
authors.initials: MA
authors.lastname: Sankardas
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D002423:Cause of Death; D016001:Confidence Intervals; D017023:Coronary Angiography / Q000379:methods; D003430:Cross-Sectional Studies; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D062606:Tertiary Care Centers; D015912:Thrombolytic Therapy / Q000379:methods* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
keywords: Acute coronary syndrome; Outcomes; Treatment