Takieddin Siba Z, Alghamdi Naif M, Mahrous Mansour S, Alamri Bader M, Bafakeeh Qusai A, Zahrani Mohammed A
Medicine and Surgery, King Abdulaziz University Hospital, Jeddah, SAU.
Cardiology, King Abdulaziz University Hospital, Jeddah, SAU.
Cureus. 2022 Jun 20;14(6):e26113. doi: 10.7759/cureus.26113. eCollection 2022 Jun.
Background Over the previous decade, the incidence of cardiovascular diseases (CVDs) has risen in the Middle East and will increase mortality to 23 million individuals in Saudi Arabia by 2030, according to the Saudi Ministry of Health. CVDs, including acute coronary syndrome (ACS), are the most common cause of mortality globally. This study aimed to analyze the demographic and clinical characteristics of patients with ACS admitted to the coronary care unit (CCU) in a tertiary hospital in Jeddah, Saudi Arabia. To the best of our knowledge, a lack of research in this region has been undertaken. Methods This retrospective records review study was conducted in a tertiary center in Jeddah, Saudi Arabia. All patients admitted to our CCU in 2017 with a final diagnosis of ACS were retrospectively enrolled. Demographic details, coronary risk factors, investigation and procedures, management, and clinical outcomes are all part of the data. Results Of the 615 patients included in the study, 491 (79.84%) were males, 226 (36.75%) were 55-64 years old, and 161 (26.18%) were 45-54 years old. Males had a higher rate of ST-segment elevation myocardial infarction (STEMI) (214, 43.58%), while females had a higher rate of non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA) (45.96% and 37.90%, respectively). Diabetes (62.60%), dyslipidemia (62.44%), and hypertension (61.46%) were the most prevalent risk factors. Angiography and percutaneous coronary intervention (PCI) were performed in 77.72% and 61.95% of patients, respectively. Coronary artery bypass graft was only performed in 4.39% of patients. PCI was performed more frequently in patients with STEMI than in those with NSTEMI/UA (P < 0.001). A large majority of patients (99.5%) recovered and were discharged. Of the 161 (26.18%) patients who attended a follow-up visit, only 45 (33.08%) met the therapeutic objective of 1.8 mmol/L (70 mg/dl) of low-density lipoprotein cholesterol. There were 100 (16.26%) patients readmitted to the CCU, and most of these were readmitted within a year after initial admission. Readmissions were more common in females and patients diagnosed with NSTEMI/UA during initial admission (15.47% and 19.35%, respectively). Conclusion This study revealed that our most common demographics were males between 45 and 64 years, which is a decade younger than the global average. STEMI was the most common presentation. The most common modifiable cardiovascular risk factors were hypertension, diabetes, and dyslipidemia. The most common adverse event was reinfarction, which was closely linked to hypertension and diabetes. In this study, the recovery rate was higher than in studies from other countries; however, the majority of patients did not achieve the goal of cholesterol levels at follow-up. Our population's younger age at presentation necessitates greater attention and more stringent preventive strategies, such as lifestyle changes and evidence-based treatments for CVD risk factors, to reduce the incidence and burden of ACS on CCUs.
在过去十年中,中东地区心血管疾病(CVD)的发病率有所上升。据沙特卫生部称,到2030年,沙特阿拉伯的心血管疾病死亡率将增至2300万人。包括急性冠状动脉综合征(ACS)在内的心血管疾病是全球最常见的死亡原因。本研究旨在分析沙特阿拉伯吉达一家三级医院冠心病监护病房(CCU)收治的急性冠状动脉综合征患者的人口统计学和临床特征。据我们所知,该地区尚未开展相关研究。
本回顾性记录审查研究在沙特阿拉伯吉达的一家三级中心进行。回顾性纳入2017年入住我院CCU且最终诊断为急性冠状动脉综合征的所有患者。数据包括人口统计学细节、冠状动脉危险因素、检查和治疗程序、治疗及临床结局。
本研究纳入的615例患者中,491例(79.84%)为男性,226例(36.75%)年龄在55 - 64岁之间,161例(26.18%)年龄在45 - 54岁之间。男性ST段抬高型心肌梗死(STEMI)发生率较高(214例,43.58%),而女性非ST段抬高型心肌梗死(NSTEMI)和不稳定型心绞痛(UA)发生率较高(分别为45.96%和37.90%)。糖尿病(62.60%)、血脂异常(62.44%)和高血压(61.46%)是最常见的危险因素。分别有77.72%和61.95%的患者接受了血管造影和经皮冠状动脉介入治疗(PCI)。仅4.39%的患者接受了冠状动脉旁路移植术。STEMI患者接受PCI的频率高于NSTEMI/UA患者(P < 0.001)。绝大多数患者(99.5%)康复出院。在161例(26.18%)接受随访的患者中,只有45例(33.08%)达到了低密度脂蛋白胆固醇1.8 mmol/L(70 mg/dl)的治疗目标。有100例(16.26%)患者再次入住CCU,其中大多数在首次入院后一年内再次入院。再次入院在女性以及初次入院时诊断为NSTEMI/UA的患者中更为常见(分别为15.47%和19.35%)。
本研究表明,我们这里最常见的人群是45至64岁的男性,比全球平均年龄小十岁。STEMI是最常见的表现形式。最常见的可改变心血管危险因素是高血压、糖尿病和血脂异常。最常见不良事件是再梗死,这与高血压和糖尿病密切相关。在本研究中,康复率高于其他国家的研究;然而,大多数患者在随访时未达到胆固醇水平目标。我们研究人群发病年龄较轻,因此需要更多关注以及更严格的预防策略,如改变生活方式和对心血管疾病危险因素进行循证治疗,以降低急性冠状动脉综合征在冠心病监护病房的发病率和负担。