Acute coronary syndromes: Clinical characteristics, management, and outcomes at the American University of Beirut Medical Center, 2002-2005

Abstract

Objectives: Data on acute coronary syndromes (ACS) in developing countries is scarce. In this report, we analyze the temporal trends in the management and outcomes of a large series of ACS patients hospitalized at the American University of Beirut Medical Center (AUBMC), a tertiary referral university hospital located in a middle income Middle Eastern developing country. Methods: A total of 1025 consecutive patients hospitalized and discharged with the diagnosis of ACS were enrolled between 2002 and 2005. The utilization of evidence-based therapies and in-hospital outcomes were determined. Results: The study enrolled 228 patients (22%) with ST-elevationmyocardial infarction (STEMI), 275 patients (27%)with non-ST-elevationmyocardial infarction (NSTEMI), and 522 patients (51%)with unstable angina. The STEMI group was younger and had a higher percentage ofmen. The utilization rates of coronary angiography and percutaneouscoronary intervention(PCI)were highest in the STEMI group. Comparison to earlierACS data (1997-1998) from the same hospital, showed an increase in the utilization of reperfusion therapy, coronary angioplasty, bypass surgery, aspirin, β-blockers, angiotensin-convertingenzymes (ACE), angiotensin receptor blockers (ARB), and statins over the past decade (P < .05). This was associatedwith a significant decrease in hospitalmortality (13%-7.7%, P < .01). Conclusions: This study analyzes one of the largest series of ACS patients reported from a single center in a developing country. The utilization of evidence-based therapies in the management of ACS at AUBMC has improved significantly over the past decade with an associated decrease in hospitalmortality. © 2010 Wiley Periodicals, Inc.