Risk Factors and Outcome of Medically Treated Acute Coronary Syndromes

A retrospective study included patients admitted to an in-tensive care unit with a diagnosis of acute coronary syndrome from January 2000 to December 2003. Three hundred patients medical histories were reviewed. The underlying risk factors such as a pos-itive family history, diabetes mellitus, hypertension and hyper-lipidemia were obtained. The cause for admission, hospitalization du-ration, complications and mortality were all taken into consideration and compared statistically. Mean age was 55.2 ± 11.9 years with the male to female ratio of 5.8:1. Diagnoses at the time of admission were ST elevation myocardial infarction, unstable angina, and non-ST elevation myocardial infarction in 61%, 30%, 9 % of the patients, re-spectively. Thrombolytic treatment had been the golden therapeutic option for ST elevation myocardial infarction available in King Ab-dulaziz University Hospital, used by 78 % of the patients, followed by intravenous anticoagulants and other anti-ischemic medications. The procedures performed were percutaneous coronary angioplasty (3%), coronary bypass grafting (2%), and cardiac catheterization and an-giography for further intervention (45%) for the 300 patients, re-spectively. 26 % of patients developed complications. Mortality was higher among females compared to males (13.6 % versus 5.9%). In conclusion male gender, diabetes mellitus, hypertension, hyper-lipidemia, positive family history and smoking were the main as-sociated risk factors in our study. ST elevation myocardial infarction was the predominant presentation in our patients. Thrombolytic treat-ment was the available therapeutic option in our hospital.