Treatment Outcomes of Acute Coronary Syndrome Patients in Bangkok Dusit Medical Services (TOACS-BDMS)
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OBJECTIVES: The research team analyzed an acute coronary syndrome (ACS) registry from a private hospital group in Thailand. We aimed to analyze patients’ characteristics, treatment outcomes in ACS patients and compare the outcomes between ST segment elevation acute coronary syndrome (STE-ACS) and non-ST segment elevation acute coronary syndrome (NSTE-ACS).
MATERIALS AND METHODS: This is a multi-centered, retrospective review of an ACS registry with seven participating hospitals carried out between January 2017 to December 2020. Web-based data entry was used, and the data were centrally managed and analyzed.
RESULTS: A total of 2,024 ACS patients were included. Of these, patients were predominantly male (81.07%), NSTE-ACS 52.17% and the mean age was 62.27 ± 13.08 years. Diabetes mellitus (DM), hypertension (HT), dyslipidemia, and current smokers were observed in 25.24%,54.89%,46.64% and 30.38%, respectively. Reperfusion rate in STE-ACS was 93.20 % and 73.80% was primary percutaneous coronary intervention (PCI). STE-ACS patients were significantly younger (59.03 ± 12.27 vs. 65.24 ± 13.09 years),more current smokers (39.77% vs. 21.78%), more cardiogenic shock (15.28%vs. 3.03%) and more cardiac arrest before reperfusion therapy (9.71% vs.1.79%). Meanwhile, NSTE-ACS patients presented significantly more DM(30.58% vs. 19.42%), HT (62.40% vs.46.69%), and dyslipidemia (53.78%vs.38.84%). In-hospital mortality rate was 2.91% and significantly higher in STE-ACS (STE-ACS 4.95% vs. NSTE-ACS 1.04%).
CONCLUSION: Treatment outcomes of ACS patients in Bangkok Dusit Medical Services revealed high reperfusion rate and resulted in low inhospital mortality rate. STE-ACS patients were more severe and with a higher mortality rate compared to NSTE-ACS patients.
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Srimahachota S., Kanjanavanit R, Boonyaratavej S, Boonsom W, Veerakul G, Tresukosol. Demographic, management practice and in-hospital outcomes of Thai Acute Coronary Syndrome Registry (TACSR): the difference from the Western world. J Med Assoc Thai 2007;90 (suppl 1):1-11
Srimahachota S, Boonyaratavej S, Kanjanavanit R, Sritara P, Krittayaphong R, Kunjara-Na-ayudhya R, et al. Thai Registry in Acute Coronary Syndrome (TRACS)--an extension of Thai Acute Coronary Syndrome registry (TACS) group: lower in-hospital but still high mortality at one-year. Journal of the Medical Association of Thailand. 2012;95(4):508-18.
Kim Y, Ahn Y, Cho MC, Kim CJ, Kim YJ, Jeong MH. Status of acute myocardial infarction in Korea. The Korean journal of internal medicine. 2019;34(1):1-10.
Jr G, Jaguszewski M, et al. Current outcome of acute coronary syndromes: data from the Zurich-Acute Coronary Syndrome (Z-ACS)-Registry. Cardiovascular Medicine. 2013; Cardiovascular Medicine 2013:115–22.
Steg PG, Goldberg RJ, Gore JM, Fox KA, Eagle KA, Flather MD, et al. Baseline characteristics, management practice and in-hospital outcomes in the Global Registry of Acute Coronary Events (GRACE). Am J Cardiol 2002; 90:358-63
W.A Wan Ahmad. Annual Report of the NCVD-ACS Registry, 2014 – 2015. Kuala Lumpur, Malaysia: National Cardiovascular Disease Database; 2017.
Anek Kanoksilp. Thai ACS Registry 2022, Report from Central Chest Institute of Thailand, Department of Medical Services, Ministry of public health
Lori Mandelzweig, Alex Battler, Valentina Boyko, Hector Bueno, Nicolas Danchin, Gerasimos Filippatos et al. The second Euro Heart Survey on acute coronary syndromes: characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean
Basin in 2004. European Heart Journal (2006) 27, 2285–2293
Negi PC, Merwaha R, Panday D, Chauhan V, Guleri R. Multicenter HP ACS Registry. Indian heart journal. 2016;68(2):118-27
Josephine Harrington, W. Schuyler Jones, Jacob A. Udell, Karen Hannan, Deepak L. Bhatt, Stefan D. Anker, et al. Acute Decompensated Heart Failure in the Setting of Acute Coronary Syndrome. J Am Coll Cardiol HF. 2022;10(6):404–414.
Goldberg RJ, Samad NA, Yarzebski J, et al. Temporal trends in cardiogenic shock complicating acute myocardial infarction. N Engl J Med. 1999; 340: 1162–8.
Hasdai D, Behar S, Wallentin L, et al. A prospective survey of the characteristics, treatments, and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). Eur Heart J. 2002; 23: 1190–201.
Goldberg RJ, Spencer FA, Gore JM, Lessard D, Yarzebski J. Thirty-year trends (1975 to 2005) in the magnitude of, management of, and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction: a population-based perspective. Circulation. 2009; 119: 1211–9. 4.
Aissaoui N, Puymirat E, Tabone X, Charbonnier B, Schiele F, Lefevre T, et al. Improved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the USIK 1995, USIC 2000, and FAST-MI French Nationwide Registries. Eur Heart J. 2012; 33: 2535–43.
Jeger RV, Radovanovic D, Hunziker PR, Pfisterer ME, Stauffer JC, Erne P, et al. Ten-year incidence, and treatment of cardiogenic shock. Ann Intern Med. 2008; 149: 618–26.
Monique L. Anderson, Eric D. Peterson, S. Andrew Peng, Tracy Y. Wang, Magnus Ohman, Deepak L. Bhatt, et al. Differences in the Profile, Treatment, and Prognosis of Patients with Cardiogenic Shock by Myocardial Infarction Classification A Report From NCDR. Circ Cardiovasc Qual Outcomes. 2013; 6:708-715.
Petr Tousek, David Bauer, Marek Neuberg, Marketa Novackova, Petr Masek, Petr Tuma et al. Patient characteristics, treatment strategy, outcomes, and hospital costs of acute coronary syndrome: 3 years of data from a large high-volume Centre in Central Europe. European Heart Journal Supplements (2022) 24 (Supplement B), B3–B9.
K.A. fox, S.G. Goodman, W. Klein, et al., Management of acute coronary syndromes, variations in practice and outcome; findings from the Global registry of Acute Coronary Events (GRACE), Eur. Heart J,23 (2002) 1177-1189
M. Nakamura, T. Yamashita, J. Yajima, et al. Clinical outcome after acute coronary syndrome in Japanese patients: observation cohort study. J Cardil.55(2010), 69-76
Thiele H, Desch S, Piek JJ, Stepinska J, Oldroyd K, Serpytis P, et al. Multivessel versus culprit lesion only percutaneous revascularization plus potential staged revascularization in patients with acute myocardial infarction complicated by cardiogenic shock: Design and rationale of CULPRIT-SHOCK trial. Am Heart J. 2016; 172: 160–9
K.H. Lee, M.h. Jeong, Y, Ahn et al., New horizons of acute myocardial infarction: from the Korea acute Myocardial Infarction registry, J Korean Med. Sci28 (2013);173-180
Kensuke Takagi, Akihito Tanaka, Naoki Yoshioka et al., In-hospital mortality among consecutive patients with ST-Elevation myocardial infarction in modern primary percutaneous intervention era ~ Insights from 15-year data of single-center hospital-based registry, PLOS ONE | https://doi.org/10.1371/journal.pone.0252503 June 11, 2021