Current Practice in Management of Acute Coronary Syndrome in Tertiary Iraqi Cardiac Centers
Kerbala Journal of Medicine,
2018, Volume 11, Issue 2, Pages 3988-3992
Abstractbackground There is continued debate as to whether a routine, early invasive strategy is superior to a conservative strategy for the management of acute coronary syndromes.
Aim of the study: To verify current practice in the setting of management of acute coronary syndromes in tertiary cardiac centers in Iraq.
Patients and methods Four hundred (400) patients were included in this study from 1st of January 2012 to 1st of January 2013from two tertiary Iraqi cardiac centers. Three hundred (300) patients from Ibn Albitar hospital and One hundred (100) patients from Iraqi center for heart disease refered to them as group (A) and group (B) respectively.
Results & discussion Mean age for all patients was54.6±9.9 year. In group A there was 208 male patients (69.3%), 92 female patients (30.6%), in group B there was 65 male patients (65%), 25 female patients (25%).
Low score (using thrombolysis in myocardial infarction score) found in 166(41.6%), intermediate score in 221 (55.3%), high in 13 (3.3%), no patients with high score was found in group B, mean TIMI score in group A was 1.61±0.5, in group B was 1.60±0.5 (P value NS). In group A UA found in 249 (83%), STEMI in 23 (7.7%), NSTEMI in 28 (9.3%).In group B UA in 79 (79%), STEMI in16 (16%), NSTEMI in 5 (5%) (Pvalue0.02). Smoking is prevalent more in group A (186 patients (62%) versus 43 patients (34%) in group B), while diabetes mellitus and family history of premature coronary artery were more prevalent in group B (Pvalue0.03).
All patients in group A with low score were treated medically while in group B with low score treated invasively. Invasive approach was more in group B compared with group A in intermerdiate risk score.
Normal coronaries were found in (3.3%) in group A versus (6.8%) in group B. Percutaneous coronary intervention was applied in (66.6%) in group A versus (50%)in group B, surgery used in (23.3%)in group A versus (28.3%)in group B, medical treatment in (10%) in group A versus (21.6%) in group B.
There were no statistical difference between both groups regarding duration of admission to hospital and mortality.
Conclusion Management of acute coronary syndromes was the same between tertiary cardiac centers and it is progressing significantly in our country.
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