Presenter Information

Dr Sadia Arshad, Aga Khan University


Executive Dining Hall

Start Date

26-2-2014 4:40 PM


Background: Acute coronary syndrome, which is a clinical syndrome encompassing the presentation of patients having unstable angina , non ST elevation myocardial infarction and and ST elevation myocardial infarction, is one of the most common diagnoses of patients admitted to tertiary care centres

Objectives: To assess the clinical characteristics , treatment given and outcomes of patients admitted to three centers with the diagnosis of acute coronary syndrome

Methods: This was a descriptive study conducted over 24 months in the cardiology departments of the Aga Khan University Hospital, Tabba Heart Institute, and Civil Hospital Karachi.

Patients were prospectively enrolled from the emergency departments of all three centers and screened for eligibility. The patients were followed till death or discharge from the hospital for outcome data.

Results: A total of 1430 patients were enrolled from 3 centers, (AKU=397 THI=692 and from CHK=341). Mean age was 63.7±18 years. All three centers revealed a strong male preponderance (75%). A large proportion of patients were diabetic (35%) and hypertensive (47%) ,less than one fifth had had a prior MI. 42% were current or ex smokers.. Shortest time to presentation in emergency room was seen in patients from CHK (mean time from symptom onset to arrival was 2.6 ±3.83 Hours vs THI (6.84± 5.8 hours) and AKU ( 6.65±8.2 hours)

Majority of patients enrolled in this study had a diagnosis of myocardial infarction 73% and the remainder had unstable angina. We found a higher than expected percentage of ST elevation in the patients with MI (66%), mostly anterior.

Patients were mostly treated according to the guidelines. A smaller than expected proportion of eligible patients underwent thrombolysis (34%). Primary PCI was performed in 285/682 (42%) and rescue PCI in 3.3%

Mean LVEF was 48.2±17%. A total of 34 (2.3% patients died during admission)

Conclusion: Patients with ACS were predominately male ,had a higher proportion of STEMI, and underwent catheter based intervention more than expected in this series. Mortality was lower than expected.

Keywords: Acute coronary syndrome, STEMI, NSTEMI, Unstable angina


Feb 26th, 4:40 PM Feb 26th, 4:50 PM

A Clinical Profile of Patients Enrolled in the Pakistan ACS Registry

Executive Dining Hall