Characteristics of In-Hospital Mortality among Patients with Acute Coronary Syndrome: A Single-Center Study in West Java, Indonesia

Dennis Bonang Tessy; Miftah Pramudyo; Charlotte Johanna Cool

doi:10.15850/amj.v8n2.2281

Characteristics of In-Hospital Mortality among Patients with Acute Coronary Syndrome: A Single-Center Study in West Java, Indonesia

Dennis Bonang Tessy, Miftah Pramudyo, Charlotte Johanna Cool

Abstract

Background: Acute Coronary Syndrome (ACS) is a severe manifestation of coronary artery disease, classified into unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). In-hospital mortality in patients with ACS remains high despite the advancement of therapy. This study aimed to evaluate the characteristics of in-hospital mortality among ACS patients in West Java, Indonesia.

Methods: This descriptive cross-sectional study analyzed retrospective secondary data of ACS patients who died during hospitalization in the period of July 2018 to June 2019 that were recorded in the ACS registry.

Results: A total of 17 patients died during hospitalization in the study period. The mean age was 64.1 years, predominantly female (n=10). The prevalent diagnoses were STEMI (n=11) and NSTEMI (n=6). Interestingly, no patients had died from UA. Hypertension was the most frequent risk factor (11 of 17). Mortality among Killip Class I, II, III, and IV were 7, 5, 1, and 4 patients, respectively. The number of patients who died after underwent Percutaneous Coronary Intervention (PCI) was lower (n=6) than those who did not undergo PCI or those without revascularization (n=11).

Conclusions: The incidence of in-hospital mortality with acute coronary syndrome is high in females, STEMI diagnosis, Killip Class I, and no revascularization.

Keywords

Acute coronary syndrome, characteristics, in-hospital mortality

Full Text:

PDF

References

Reed GW, Rossi JE, Cannon CP. Acute myocardial infarction. Lancet. 2017;389(10065):197–210.

World Health Organization. About cardiovascular diseases [Internet]. 2020 [cited 2020 Jun 23]. Available from: https://www.who.int/cardiovascular_diseases/about_cvd/en/

Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan Republik Indonesia. Riset Kesehatan Dasar (Riskesdas) 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan Republik Indonesia; 2019.

Anggraini R, Wihastuti TA, Ningsih DK. The differences of correlation of the TIMI, GRACE, and Killip risk scores as predictor prognosis patients with non ST-elevation myocard infarction acute coronary syndrome in ICCU RSUD Dr. Iskak Tulungagung. Jurnal Ilmu Keperawatan. 2018;6(1):79–87.

Everett CC, Fox KAA, Reynolds C, Fernandez C, Sharples L, Stocken DD, et al. Evaluation of the impact of the GRACE risk score on the management and outcome of patients hospitalised with non-ST elevation acute coronary syndrome in the UK: protocol of the UKGRIS cluster-randomised registry-based trial. BMJ Open. 2019;9(9):e032165.

Gayatri NI, Firmansyah S, Hidayat S, Rudiktyo E. Prediktor mortalitas dalam-rumah-sakit pasien infark miokard ST Elevasi (STEMI) akut di RSUD dr. Dradjat Prawiranegara Serang, Indonesia. CDK. 2016;43(3):171–4.

Ray M, Ruthazer R, Beshansky JR, Kent DM, Mukherjee JT, Alkofide H, et al. A predictive model to identify patients with suspected acute coronary syndromes at high risk of cardiac arrest or in-hospital mortality: An IMMEDIATE Trial sub-study. Int J Cardiol Heart Vasc. 2015;9:37–42.

Badan Pusat Statistika. Data Kota Bandung 2018: indeks pembangunan manusia [Internet]. [cited 2020 Nov 23]. Available from: https://ipm.bps.go.id/data/kabkot/metode/baru/3273

Hao Y, Liu J, Liu J, Yang N, Smith Jr SC, Huo Y, et al. Sex differences in in-hospital management and outcomes of patients with acute coronary syndrome. Circulation. 2019;139(15):1776–85.

Gong IY, Goodman SG, Brieger D, Gale CP, Chew DP, Welsh RC, et al. GRACE risk score: Sex-based validity of in-hospital mortality prediction in Canadian patients with acute coronary syndrome. Int J Cardiol. 2017;244:24–9.

Nastiti G. Prediktor kematian dalam perawatan rumah sakit pada pasien sindrom koroner akut di RSUP Dr. Hasan Sadikin Bandung [dissertation]. Bandung: Universitas Padjadjaran; 2020.

Singh S, Paul S, Pal R, Thatkar P. Acute coronary syndrome-related mortality audit in a teaching hospital at Port Blair, India. J Family Med Prim Care. 2017;6(3):502-508.

Saquib N, Saquib J, Alhadlag A, Albakour MA, Aljumah B, Sughayyir M, et al. Chronic disease prevalence among elderly Saudi men. Int J Health Sci (Qassim). 2017;11(5):11–6.

El-Menyar A, Zubaid M, Almahmeed W, Sulaiman K, Alnabti A, Singh R, et al. Killip classification in patients with acute coronary syndrome: Insight from a multicenter registry. Am J Emerg Med. 2012;30(1):97–103.

Budzianowski J, Pieszko K, Burchardt P, Rzeźniczak J, Hiczkiewicz J. The role of hematological indices in patients with acute coronary syndrome. Dis Markers. 2017;2017:3041565.

Mamas MA, Kwok CS, Kontopantelis E, Fryer AA, Buchan I, Bachmann MO, et al. Relationship between anemia and mortality outcomes in a National Acute Coronary Syndrome Cohort: Insights from the UK Myocardial Ischemia National Audit Project Registry. J Am Heart Assoc. 2016;5(11):e003348.

Moady G, Iakobishvili Z, Beigel R, Shlomo N, Matetzky S, Zahger D, et al. The predictive value of low admission hemoglobin over the GRACE score in patients with acute coronary syndrome. J Cardiol. 2019;73(4):271–5.

Dharma S, Andriantoro H, Purnawan I, Dakota I, Basalamah F, Hartono B, et al. Characteristics, treatment and in-hospital outcomes of patients with STEMI in a metropolitan area of a developing country: an initial report of the extended Jakarta Acute Coronary Syndrome registry. BMJ Open. 2016;6(8):e012193.

DOI: https://doi.org/10.15850/amj.v8n2.2281