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‐elevation myocardial infarction (STEMI), 275 patients (27%) with non‐ST‐elevation myocardial infarction (NSTEMI), and 522 patients (51%) with unstable angina. The STEMI group was younger and had a higher percentage of men. The utilization rates of coronary angiography and percutaneous coronary intervention (PCI) were highest in the STEMI group. Comparison to earlier ACS data (1997–1998) from the same hospital, showed an increase in the utilization of reperfusion therapy, coronary angioplasty, bypass surgery, aspirin, β‐blockers, angiotensin‐converting enzymes (ACE), angiotensin receptor blockers (ARB), and statins over the past decade (P < .05). This was associated with a significant decrease in hospital mortality (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 hospital mortality. Copyright © 2009 Wiley Periodicals, Inc.
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