National Heart Institute Acute Coronary Syndrome Registry

Objective: Acute coronary syndromes (ACS) represent the acute life threatening phase of coronary artery disease , registries and surveys have the potential to define the gaps between evidence and practice as well as implementation of guidelines.Aim of the Work: To assess the application of a newly designed registry among Egyptian patients with ACS and to compare the results with those of other international registries.Methods: The study included 401 patients having acute coronary syndrome admitted to the National Heart Institute CCU over 6 months from January 2007 to June 2007 that were subjected to full history clinical examination, 12 leads, ECG, and echocardiography. Patients were classified according to the ECG at presentation into ACS with ST elevation, ACS without ST Elevation, and ACS with undetermined ECG changes. Patients were managed according to the ACC/AHA guidelines 2004 for STEMI update 2002 for unstable angina and NSTEMI, In hospital MACE; death, re-infarction, target vessel revascularization and rrhythmias were assessed.Results: ACS with ST elevation was the most common presentation (59.1 %), age of our study population ranges from 18 to 88 years old (54.5±11.9 years). Most of patients were males (79%), smoking was the most significant risk factor (61 %) followed by Hypertension (55%). The main presenting symptom was typical anginal chest pain (91.5%).Coronary angiography was performed in 40% of our study population with higher incidence among patients who had ACS with undetermined ECG changes (44.12%), however reperfusion by PCI was undertaken in a higher percentage of patients with ACS with ST elevation (30.38%).In patients diagnosed as STEMI (267 patients), 65.5% of the patients received thrombolysis “Streptokinase”, while 12.4% were referred for primary PCI.Heart failure was the most prevalent in hospital compli-cation, Atrial fibrillation was the most common occurring arrhythmia.Conclusions: Smoking hypertension are significant risk factors among Egyptian patients. The use of invasive strategy was restricted to the most critical patients; this was because of financial causes.