TY - JOUR
T1 - Characteristics and the average 30-day and 6-month clinical outcomes of patients hospitalised with coronary artery disease in a poor South-East Asian setting
T2 - The first cohort from Makassar Cardiac Center, Indonesia
AU - Qanitha, Andriany
AU - Uiterwaal, Cuno S.P.M.
AU - Henriques, Jose P.S.
AU - Alkatiri, Abdul Hakim
AU - Mappangara, Idar
AU - Mappahya, Ali Aspar
AU - Patellongi, Ilhamjaya
AU - De Mol, Bastianus A.J.M.
N1 - Funding Information:
Funding This work was supported by Directorate General of Higher Education/ Direktorat Jenderal Pendidikan Tinggi (DIKTI), Ministry of National Education Republic of Indonesia (grant number 600/E4.4/K/2011, 2011).
Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Objective To provide a detailed description of characteristics at hospital admission and clinical outcomes at 30-day and 6-month follow-up in patients hospitalised with coronary artery disease (CAD) in a poor South-East Asian setting. Design Prospective observational cohort study. Setting From February 2013 to December 2014, in Makassar Cardiac Center, Indonesia. Participants 477 patients with CAD (acute coronary syndrome and stable CAD). Outcome measures All-cause mortality and major adverse cardiovascular events (MACE). Results Out of 477 patients with CAD, the proportion of young age (<60 years) was 53.9% and 72.7% were male. At admission, 44.2% of patients were diagnosed with ST-segment elevation myocardial infarction (STEMI), 38.6% with diagnosis or signs of heart failure and 75.1% had previous hypertension. Out of 211 patients with STEMI, only 4.7% had been treated with primary percutaneous coronary intervention (PCI) and 6.2% received thrombolysis. The time lapse from symptom onset to hospital admission was 26.8 (IQR 10.0-48.0) hours, and 19.1% of all patients had undergone either PCI or coronary artery bypass graft. The survival rate at 6 months was 78.9%. The rates of all-cause mortality at 30 days and 6 months were 13.4% and 7.3%, respectively; the rate of composite MACE at 30 days was 26.2% and 18.0% at 6 months. Conclusions Patients with CAD from a poor South-East Asian setting present themselves with predominantly unstable conditions of premature CAD. These patients show relatively severe illness, have significant time delay from symptom onset to admission or intervention, and most do not receive the guidelines-recommended treatment. Awareness of symptoms, prompt initial management of acute CVD, well-established infrastructures and resources both in primary and secondary hospital for CVD should be improved to reduce the high rates of 30-day and 6-month mortality and adverse outcomes in this population.
AB - Objective To provide a detailed description of characteristics at hospital admission and clinical outcomes at 30-day and 6-month follow-up in patients hospitalised with coronary artery disease (CAD) in a poor South-East Asian setting. Design Prospective observational cohort study. Setting From February 2013 to December 2014, in Makassar Cardiac Center, Indonesia. Participants 477 patients with CAD (acute coronary syndrome and stable CAD). Outcome measures All-cause mortality and major adverse cardiovascular events (MACE). Results Out of 477 patients with CAD, the proportion of young age (<60 years) was 53.9% and 72.7% were male. At admission, 44.2% of patients were diagnosed with ST-segment elevation myocardial infarction (STEMI), 38.6% with diagnosis or signs of heart failure and 75.1% had previous hypertension. Out of 211 patients with STEMI, only 4.7% had been treated with primary percutaneous coronary intervention (PCI) and 6.2% received thrombolysis. The time lapse from symptom onset to hospital admission was 26.8 (IQR 10.0-48.0) hours, and 19.1% of all patients had undergone either PCI or coronary artery bypass graft. The survival rate at 6 months was 78.9%. The rates of all-cause mortality at 30 days and 6 months were 13.4% and 7.3%, respectively; the rate of composite MACE at 30 days was 26.2% and 18.0% at 6 months. Conclusions Patients with CAD from a poor South-East Asian setting present themselves with predominantly unstable conditions of premature CAD. These patients show relatively severe illness, have significant time delay from symptom onset to admission or intervention, and most do not receive the guidelines-recommended treatment. Awareness of symptoms, prompt initial management of acute CVD, well-established infrastructures and resources both in primary and secondary hospital for CVD should be improved to reduce the high rates of 30-day and 6-month mortality and adverse outcomes in this population.
KW - Cardiovascular outcomes
KW - Coronary heart disease
KW - Major adverse cardiovascular events
KW - Mortality rate
KW - Poor setting
UR - http://www.scopus.com/inward/record.url?scp=85049133894&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-021996
DO - 10.1136/bmjopen-2018-021996
M3 - Article
AN - SCOPUS:85049133894
SN - 2044-6055
VL - 8
JO - BMJ Open
JF - BMJ Open
IS - 6
M1 - e021996
ER -