The Crowd of Acute Coronary Syndrome in a Rural Emergency Room of Pakistan: Distribution of Demographic, Clinical, and Angiographic Characteristics

Objectives: Data are available regarding pattern of acute coronary syndrome (ACS) in urban areas of Southeast Asia. We conducted a study to assess the demographic, clinical, and angiographic characteristics and management strategies in patient presenting with ACS arriving in emergency room (ER) of satellite center located in rural area. Methodology: It was a cross-sectional study done at tertiary cardiac care center located in rural area of Pakistan. In February to March 2021, 355 patients with ACS were included in this study. Patients were categorized into STEMI (ST-segment elevation myocardial infarction), NSTEMI (Non ST-segment elevation myocardial infarction), and USA (unstable angina). Results: A total number of 4210 patients visited the ER out of which 355 patients were with ACS. Mean age was 56±10 years and 43% of patients were <60 years of age, 80.6% of patients were male and presentation with symptoms duration of ranging from 1 hour to 7 days range. Hypertension was prevalent in (52.7%) followed by diabetes in 33% and smoking (29%). STEMI and NSTEMI were the predominant types of ACS (50.4% and 33.5%). Primary PCI was done in 97% of eligible patient presenting within window period and percutaneous revascularization was performed in 69% of ACS patients. In-hospital mortality was noted in 1.1%. Conclusion: STEMI and NSTEMI were the predominant type of ACS. Majority of patients were male and hypertension was the most prevalent risk factor followed by diabetes and smoking. Significant improvement has been achieved in the management of ACS with in-hospital mortality remain 1.1%.