Demographics and Characteristics of Patients Admitted With Acute Coronary Syndrome to the Coronary Care Unit at King Abdulaziz University

Abstract

BackgroundOver the previous decade, the incidence of cardiovascular diseases (CVDs) has risen in the Middle East and will increase mortality to 23 million individuals in Saudi Arabia by 2030, according to the Saudi Ministry of Health. CVDs, including acute coronary syndrome (ACS), are the most common cause of mortality globally. This study aimed to analyze the demographic and clinical characteristics of patients with ACS admitted to the coronary care unit (CCU) in a tertiary hospital in Jeddah, Saudi Arabia. To the best of our knowledge, a lack of research in this region has been undertaken. MethodsThis retrospective records review study was conducted in a tertiary center in Jeddah, Saudi Arabia. All patients admitted to our CCU in 2017 with a final diagnosis of ACS were retrospectively enrolled. Demographic details, coronary risk factors, investigation and procedures, management, and clinical outcomes are all part of the data. ResultsOf the 615 patients included in the study, 491 (79.84%) were males, 226 (36.75%) were 55-64 years old, and 161 (26.18%) were 45-54 years old. Males had a higher rate of ST-segment elevation myocardial infarction (STEMI) (214, 43.58%), while females had a higher rate of non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA) (45.96% and 37.90%, respectively). Diabetes (62.60%), dyslipidemia (62.44%), and hypertension (61.46%) were the most prevalent risk factors. Angiography and percutaneous coronary intervention (PCI) were performed in 77.72% and 61.95% of patients, respectively. Coronary artery bypass graft was only performed in 4.39% of patients. PCI was performed more frequently in patients with STEMI than in those with NSTEMI/UA (P < 0.001). A large majority of patients (99.5%) recovered and were discharged. Of the 161 (26.18%) patients who attended a follow-up visit, only 45 (33.08%) met the therapeutic objective of 1.8 mmol/L (70 mg/dl) of low-density lipoprotein cholesterol. There were 100 (16.26%) patients readmitted to the CCU, and most of these were readmitted within a year after initial admission. Readmissions were more common in females and patients diagnosed with NSTEMI/UA during initial admission (15.47% and 19.35%, respectively). ConclusionThis study revealed that our most common demographics were males between 45 and 64 years, which is a decade younger than the global average. STEMI was the most common presentation. The most common modifiable cardiovascular risk factors were hypertension, diabetes, and dyslipidemia. The most common adverse event was reinfarction, which was closely linked to hypertension and diabetes. In this study, the recovery rate was higher than in studies from other countries; however, the majority of patients did not achieve the goal of cholesterol levels at follow-up. Our population's younger age at presentation necessitates greater attention and more stringent preventive strategies, such as lifestyle changes and evidence-based treatments for CVD risk factors, to reduce the incidence and burden of ACS on CCUs.

A Prospective Cross-Sectional Study of Acute Coronary Syndrome Patients’ Quality of Life and Drug Prescription Patterns at Riyadh Region Hospitals, Saudi Arabia

“…Individuals aged 48 and higher were substantially more likely to get ACS. A previous study conducted in Saudi Arabia’s northern area reported that the majority of ACS cases were discovered among persons aged 46 to 55, which is similar to our findings [ 25 ]. Contrary to our result Al-Saif et al, 2012, documented that the mean age of ACS in Saudi Arabia is 58 years [ 30 ].…”

“…Furthermore, another study in Saudi Arabia’s southern region discovered that the frequency of ACS was greater in males than in females. This shows that because of the high incidence of dyslipidemia, smoking, hypertension, and diabetes among men; thus they are at a greater risk of developing ACS [ 25 ]. On the contrary, Thiruvisaakachelvy et al, 2019 revealed that there was no significant correlation between gender and ACS patients’ life quality due to the improved health care and rehabilitation services they received [ 32 ].…”

“…Recent research in Saudi Arabia demonstrated that urban individuals are more impacted by ACS than rural people. This might be due to significant consequences for healthcare services and resource use, as well as the accessibility of healthcare facilities in urban areas vs rural areas [ 25 ].…”

“…The prevalence of diabetes in the Saudi Arabian population over the age of 25 was 23.7 percent in 1995, 30.8 percent in 2013, and 39.5 percent by 2022, which might be attributed to an increase in obesity prevalence, genetic and environmental factors. Similarly, hypertension afflicted 26 percent of the population in Saudi Arabia in 1995, rising to 25.5 percent in 2005 and 28 percent in 2013 [ 25 , 36 , 37 ]. The comorbidities of diabetes mellitus and hypertension with ACS worsen the morbidity and mortality of ACS patients, as well as their quality of life.…”

“…Saudi Arabia’s 2030 vision is to enhance healthcare systems by collecting appropriate data in order to meet and manage challenges, implement preventative measures, and increase access to healthcare systems. Moreover, Saudi Arabia is divided into regions, each with its own patient demographics, clinical features, management, and quality of healthcare services [ 7 , 25 ]. As a result, the current study’s objectives seek to assess the quality of life and drug prescription patterns of ACS patients at Riyadh Region Hospitals in Saudi Arabia.…”