Presentation, management, and outcomes of 25 748 acute coronary syndrome admissions in Kerala, India: results from the Kerala ACS Registry

摘要: Aims There are limited contemporary data on the presentation, management, and outcomes of acute coronary syndrome (ACS) admissions in India. We aimed to develop a prospective registry address treatment health systems gaps management ACSs Kerala, India. Methods results prospectively collected 25 748 consecutive ACS from 2007 2009 125 hospitals Kerala. evaluated in-hospital mortality major adverse cardiovascular events (MACE). created random-effects multivariate regression models evaluate predictors while accounting for confounders. Mean (SD) age at presentation was 60 (12) years did not differ among types [ST-segment myocardial infarction (STEMI) = 37%; non-STEMI 31%; unstable angina 32%]. In-hospital anti-platelet use high (>90%). Thrombolytics were used 41% STEMI, 19% non-STEMI, 11% admissions. Percutaneous intervention rates marginally higher STEMI Discharge medication variable generally suboptimal ( 6 h [OR 2.29 (1.73, 3.02)], inappropriate thrombolysis 1.33 (0.92, 1.91)] associated with risk door-to-needle time <30 min 0.44 (0.27, 0.72)] lower mortality. Similar trends seen MACE. Conclusion These represent largest India demonstrate opportunities improving care.