Presentation and outcomes of patients with acute coronary syndromes in eastern Nepal
BACKGROUND: The burden of ischemic heart disease (IHD) in developing countries is on the rise, due to urbanisation, industrialisation and the low availability of evidence based therapies and interventions. AIMS AND OBJECTIVES:Data was collected on consecutive patients admitted with a...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2011-04-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1275 |
| _version_ | 1811194084844371968 |
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| author | NR Shreshta S Basnet R Bhandari P Acharia P Karki |
| author_facet | NR Shreshta S Basnet R Bhandari P Acharia P Karki |
| author_sort | NR Shreshta |
| collection | DOAJ |
| description |
BACKGROUND: The burden of ischemic heart disease (IHD) in developing countries is on the rise, due to urbanisation, industrialisation and the low availability of evidence based therapies and interventions.
AIMS AND OBJECTIVES:Data was collected on consecutive patients admitted with acute coronary syndrome (ACS), from 1st January to 31st December 2008, to a tertiary care centre in eastern Nepal. Final diagnosis, risk factors, educational status, time delays, treatment and in-hospital outcomes were evaluated.
RESULTS:A total of153 patients with ACS were admitted in 2008: 58 with ST elevation myocardial infarction (STEMI) (38%), 28 with non-ST elevation myocardial infarction (NSTEMI) (18%) and 67 with unstable angina (UA) (44%). 40% of patients with STEMI presented within 12 hours of symptom onset. Most patients presented late and 33% of them presented after 2 days or more. Over half the patients were not literate. Due to the unavailability of percutaneous coronary intervention (PCI) at the centre, thrombolysis with Streptokinase was considered for patients presenting with STEMI up to 24 hours after symptom onset. However, due to financial constraints, only 53% of patients in this broadened time window actually received thrombolytic treatment. The in-hospital mortality was 14% for all patients with ACS, and 17% for the patients with STEMI.
CONCLUSIONS:Only a small proportion of patients with ACS in Eastern Nepal are admitted to hospital, and those who are often arrive late, or cannot afford optimal medical management. Awareness, better referral and transport facilities, financial support for the needy, and the availability of on-site coronary angiography and angioplasty for selected patients should contribute to treat more ACS patients and improve their prognosis.
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| first_indexed | 2024-04-12T00:20:14Z |
| format | Article |
| id | doaj.art-67fe94beac6745e5be1304d19242ea2e |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-12T00:20:14Z |
| publishDate | 2011-04-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-67fe94beac6745e5be1304d19242ea2e2022-12-22T03:55:44ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972011-04-01141151610.4414/smw.2011.13174Presentation and outcomes of patients with acute coronary syndromes in eastern NepalNR ShreshtaS BasnetR BhandariP AchariaP Karki BACKGROUND: The burden of ischemic heart disease (IHD) in developing countries is on the rise, due to urbanisation, industrialisation and the low availability of evidence based therapies and interventions. AIMS AND OBJECTIVES:Data was collected on consecutive patients admitted with acute coronary syndrome (ACS), from 1st January to 31st December 2008, to a tertiary care centre in eastern Nepal. Final diagnosis, risk factors, educational status, time delays, treatment and in-hospital outcomes were evaluated. RESULTS:A total of153 patients with ACS were admitted in 2008: 58 with ST elevation myocardial infarction (STEMI) (38%), 28 with non-ST elevation myocardial infarction (NSTEMI) (18%) and 67 with unstable angina (UA) (44%). 40% of patients with STEMI presented within 12 hours of symptom onset. Most patients presented late and 33% of them presented after 2 days or more. Over half the patients were not literate. Due to the unavailability of percutaneous coronary intervention (PCI) at the centre, thrombolysis with Streptokinase was considered for patients presenting with STEMI up to 24 hours after symptom onset. However, due to financial constraints, only 53% of patients in this broadened time window actually received thrombolytic treatment. The in-hospital mortality was 14% for all patients with ACS, and 17% for the patients with STEMI. CONCLUSIONS:Only a small proportion of patients with ACS in Eastern Nepal are admitted to hospital, and those who are often arrive late, or cannot afford optimal medical management. Awareness, better referral and transport facilities, financial support for the needy, and the availability of on-site coronary angiography and angioplasty for selected patients should contribute to treat more ACS patients and improve their prognosis. https://www.smw.ch/index.php/smw/article/view/1275Acute Coronary Syndromedevelopping countriesintensive caremyocardial infarctionThrombolysis |
| spellingShingle | NR Shreshta S Basnet R Bhandari P Acharia P Karki Presentation and outcomes of patients with acute coronary syndromes in eastern Nepal Swiss Medical Weekly Acute Coronary Syndrome developping countries intensive care myocardial infarction Thrombolysis |
| title | Presentation and outcomes of patients with acute coronary syndromes in eastern Nepal |
| title_full | Presentation and outcomes of patients with acute coronary syndromes in eastern Nepal |
| title_fullStr | Presentation and outcomes of patients with acute coronary syndromes in eastern Nepal |
| title_full_unstemmed | Presentation and outcomes of patients with acute coronary syndromes in eastern Nepal |
| title_short | Presentation and outcomes of patients with acute coronary syndromes in eastern Nepal |
| title_sort | presentation and outcomes of patients with acute coronary syndromes in eastern nepal |
| topic | Acute Coronary Syndrome developping countries intensive care myocardial infarction Thrombolysis |
| url | https://www.smw.ch/index.php/smw/article/view/1275 |
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