Chand Negi Prakash, Mahajan Kunal, Merwaha Rajeev, Asotra Sanjeev, Sharma Rajesh
IGMC Shimla, HP, 171001, India.
IGMC Shimla, HP, 171001, India.
Indian Heart J. 2019 Nov-Dec;71(6):440-445. doi: 10.1016/j.ihj.2020.01.003. Epub 2020 Feb 5.
The epidemiological trends of incidence, treatment practices, and outcomes are reported from Shimla district of the northern state of India.
The data of clinical characteristics, treatment practices, and outcomes of patients with acute coronary syndrome (ACS) diagnosed using standard criteria were collected systematically from the defined hilly geographical region of the northern state of India from January 2013 to December 2018 as the part of Himachal Pradesh acute coronary syndrome (HP ACS) registry. The year-wise trends of incidence, demographic, clinical characteristics, treatment practices, and in-hospital mortality are reported.
The incidence of ACS shows declining trends. The mean age at incident ACS is increasing without change in gender predilection. The prevalence of overweight/obesity and diabetes has increased significantly since 2013 but tobacco consumption has not changed. The reperfusion therapy has increased significantly (20.9% in 2013 to 42.1% in 2018, p < 0.01) primarily because of an increased use of percutaneous coronary angioplasty. There is a trend of increasing use of beta blockers. The use of other oral secondary preventive drugs remained more than 90% since 2013. The in-hospital mortality rate is declining (9.0% in 2013 to 6.0% in 2018, p < 0.01).
Epidemiological characteristics of the ACS population in Shimla district are changing. The trends of use of reperfusion therapy in ST segment elevated myocardial infarction population has although increased but is still suboptimal, and there is a need for taking initiatives both at the system and population level to improve the reperfusion therapy.
报告印度北部喜马偕尔邦西姆拉地区急性冠状动脉综合征（ACS）的发病率、治疗方法及治疗结果的流行病学趋势。
作为喜马偕尔邦急性冠状动脉综合征（HP ACS）登记研究的一部分，于2013年1月至2018年12月，从印度北部指定的山区地理区域系统收集了使用标准标准诊断的急性冠状动脉综合征（ACS）患者的临床特征、治疗方法及治疗结果的数据。报告了发病率、人口统计学、临床特征、治疗方法及住院死亡率的逐年趋势。
ACS的发病率呈下降趋势。ACS发病时的平均年龄在增加，性别偏好无变化。自2013年以来，超重/肥胖和糖尿病的患病率显著增加，但烟草消费未变。再灌注治疗显著增加（从2013年的20.9%增至2018年的42.1%，p<0.01），主要原因是经皮冠状动脉成形术的使用增加。β受体阻滞剂的使用有增加趋势。自2013年以来，其他口服二级预防药物的使用率保持在90%以上。住院死亡率在下降（从2013年的9.0%降至2018年的6.0%，p<0.01）。
西姆拉地区ACS人群的流行病学特征正在发生变化。ST段抬高型心肌梗死人群再灌注治疗的使用趋势虽有增加，但仍未达到最佳水平，需要在系统和人群层面采取措施以改善再灌注治疗。
