Characteristics and the average 30-day and 6-month clinical outcomes of patients hospitalised with coronary artery disease in a poor South-East Asian setting: the first cohort from Makassar Cardiac Center, Indonesia

Abstract

ObjectiveTo provide a detailed description of characteristics at hospital admission and clinical outcomes at 30-day and 6-month follow-up in patients hospitalised with coronary artery disease (CAD) in a poor South-East Asian setting.DesignProspective observational cohort study.SettingFrom February 2013 to December 2014, in Makassar Cardiac Center, Indonesia.Participants477 patients with CAD (acute coronary syndrome and stable CAD).Outcome measuresAll-cause mortality and major adverse cardiovascular events (MACE).ResultsOut of 477 patients with CAD, the proportion of young age (<60 years) was 53.9% and 72.7% were male. At admission, 44.2% of patients were diagnosed with ST-segment elevation myocardial infarction (STEMI), 38.6% with diagnosis or signs of heart failure and 75.1% had previous hypertension. Out of 211 patients with STEMI, only 4.7% had been treated with primary percutaneous coronary intervention (PCI) and 6.2% received thrombolysis. The time lapse from symptom onset to hospital admission was 26.8 (IQR 10.0–48.0) hours, and 19.1% of all patients had undergone either PCI or coronary artery bypass graft. The survival rate at 6 months was 78.9%. The rates of all-cause mortality at 30 days and 6 months were 13.4% and 7.3%, respectively; the rate of composite MACE at 30 days was 26.2% and 18.0% at 6 months.ConclusionsPatients with CAD from a poor South-East Asian setting present themselves with predominantly unstable conditions of premature CAD. These patients show relatively severe illness, have significant time delay from symptom onset to admission or intervention, and most do not receive the guidelines-recommended treatment. Awareness of symptoms, prompt initial management of acute CVD, well-established infrastructures and resources both in primary and secondary hospital for CVD should be improved to reduce the high rates of 30-day and 6-month mortality and adverse outcomes in this population.

Predictive Value of Hematologic Indices in the Diagnosis of Acute Coronary Syndrome

“…Baseline characteristics for both ACS and SCAD are similar, which dominated by male and majority aged below sixty. This result is relatively similar to the previous study in Makassar, Indonesia [17]. Southeast Asian countries indeed have younger morbidity and mortality due to non-communicable disease, primarily cardiovascular disease compared to another region such as European.…”

“…Southeast Asian countries indeed have younger morbidity and mortality due to non-communicable disease, primarily cardiovascular disease compared to another region such as European. This difference may be due to a rapid epidemiological transition in Southeast Asian countries [17], [18].…”

“…Other than a high grade of inflammation, risk factor such as smoking also contributes to oxidative stress [23]. Study in Indonesia has shown that ACS patients have a higher number of smoker compared to SCAD patient [17].…”

Predictors of Quality of Life Quality of Adults with Coronary Artery Disease (CAD)

“…This in line with data indicate half of the world's cardiovascular burden is estimated to occur in Asia [8], and the prevalence of symptomatic heart failure appears to be higher in South East Asia countries compared with the rest of the world [9]. Despite the high burden of cardiovascular disease in South-East Asia, little is known about characteristics at admission and clinical outcomes in patients with coronary artery disease, especially acute coronary syndrome [10].…”

Parameter Klinis dan Ekokardiografi Strain untuk Memprediksi Keparahan Stenosis Berdasar Skor Gensini pada Penyakit Jantung Koroner Stabil

“…Jika dibandingkan dengan penelitianpenelitian di negara barat, rerata usia tersebut relatif lebih muda, namun jika dibanding dengan data di Asia Tenggara hampir serupa. [7][8][9][10][11] Subjek laki-laki lebih banyak dibanding perempuan (72% dibandingkan 28%). Proporsi pasien laki-laki pada penelitian-penelitian lain bervariasi, baik di negara Barat maupun di Asia.…”