Dr. Abida Bashir, Dr. Zainab Tariq, Dr. Tayyaba Khalid
Objective: While doing the study on Aspirin Awareness and Usage (AAUS) in cases of Acute Coronary Syndrome (ACS), AAUS study Group designed the protocol to include the profile of patients presenting with symptoms of ACS and in the light of that also reviewed the available data in Pakistani population. Methodology: It was a prospective study conducted in the acute coronary care units (CCUs) of Punjab Institute of Cardiology Lahore for two years duration from April 2018 to April 2020. Patients included men and women of all age groups with chest pain who were diagnosed with coronary artery disease (CAD) and classified for unstable angina (USA), STEMI or NSTEMI based on clinical, ECG and enzyme criteria. Risk factors, family history, diet history, time to ER after symptom onset, ACS management in the ICU, and treatment outcome were recorded. Results: A total of 1,527 patients presented to the ED with chest pain, but approximately 1,400 patients were assessed. The majority (68%) were men. The mean age of all patients was 52.2 ± 10.7 years. 28.3% of patients were <45 years of age. The mean time to presentation in the emergency room was 13.2 ± 6.2 hours. 92.7% of patients reported chest pain. More than half of the patients had hypertension (55.2%) and / or smoking (52%) as risk factors, while 37.2% had diabetes and 18.2% had hyperlipidemia. Hypertension (52.7%), IHD (44%) and diabetes (36.2%) were important in the family history. The United States and STEMI were the main types of ACS (43.0% and 40.5%, respectively). At the time of discharge, 67.8% of patients were stable without symptoms, 13.3% with symptoms, 16.4% were referred for further testing, and 2.5% had died. Conclusions: Review of the available data in Pakistan, supported by the current study on a cohort of 1,400 patients, the emerging profile of AMI patients is that the majority are male, relatively younger compared to the Western population, smoking and hypertension followed by diabetes are the major risk factors. The unstable angina and STEMI are the dominant types of ACS, and most patients likely have high blood pressure, IHD, and diabetes in their families. Better control of risk factors and awareness of prevention strategies are needed. KEYWORDS: Acute Coronary Syndrome (ACS), Acute Myocardial Infarction (AMI), Risk Factors, Ischemic Heart Disease, Profile.