Why the study?
Cardiovascular disease is the leading cause of death in Egypt, and few registries have analyzed acute coronary syndrome patients admitted to critical care in Egypt.
Does interventional treatment reduce major adverse cardiac events in patients with acute coronary syndrome compared to conservative treatment?
Cohort (n=503)
No
Does interventional treatment reduce major adverse cardiac events in patients with acute coronary syndrome compared to conservative treatment?
Absolute Event Rate: 13.5% vs 23.4%
p-value: p=0.031
Early interventional treatment is associated with a lower incidence of major adverse cardiac events in patients with acute coronary syndrome, particularly UA/NSTEMI, in an Egyptian cohort.
Supports early revascularization in Egyptian ACS patients to lower MACE risk; leaves open generalizability to current practice and other populations.
Background Cardiovascular disease is the leading cause of death in Egypt and worldwide, placing great strain on the world’s health systems. This is one of the few Egyptian registries dealing with patients with acute coronary syndrome admitted in critical care department, Cairo University. Methods This is a retrospective non-controlled cohort study of patients with acute coronary syndrome admitted from January 2010 to December 2012. Retrospective analysis of these patients data were retrieved through reviewing written paper and electronic database. Results A total number of 503 patients were enrolled in our study. The mean age was 57.2 ± 10.4 years. Their pain duration was 14 ± 24.4 h. Average length of stay was (7 ± 4.4 days). Primary percutaneous coronary intervention (PCI) was done to 154 patients (30.6%), while we had 105 elective PCI procedures (20.9%). Major adverse cardiac events (MACE) were higher in patients with higher age (60 years vs 56.7 years P value 0.021), STEMI (25.7% vs. 18% in UA/NSTEMI P value 0.002), higher CKMB levels (157iu/l vs 89iu/l P value0.019), and higher Killip class upon presentation (class III-IV 64.9% vs 2.2% class I-II p < 0.001). Patients with UA/NSTEMI who were treated conservatively developed statistically significant higher incidence of MACE as compared to those treated interventionally (23.4% vs. 13.5% P value 0.031). Patients with STEMI who were treated without intervention have significant higher incidence of MACE than those who were treated interventionally (15.4% vs. 5.5% p = 0.46). Conclusion 1. Higher incidence of MACE was observed in the higher age group, higher levels of cardiac biomarkers, and higher Killip class. 2. Outcome was affected by early interventional treatment in all patient groups.
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Tawfeek et al. (2016) conducted a cohort in Acute coronary syndrome (n=503). Interventional treatment (PCI) vs. Conservative treatment was evaluated on Major adverse cardiac events (MACE) (p=0.031).
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