PMID- 21491212
OWN - NLM
STAT- MEDLINE
DCOM- 20110729
LR  - 20191210
IS  - 1424-3997 (Electronic)
IS  - 0036-7672 (Linking)
VI  - 141
DP  - 2011
TI  - Presentation and outcome of patients with acute coronary syndromes in eastern 
      Nepal.
PG  - w13174
LID - 10.4414/smw.2011.13174 [doi]
AB  - BACKGROUND: The burden of ischemic heart disease (IHD) in developing countries is 
      on the rise, due to urbanisation, industrialisation and the low availability of 
      evidence based therapies and interventions. AIMS AND OBJECTIVES: Data was 
      collected on consecutive patients admitted with acute coronary syndrome (ACS), 
      from 1st January to 31st December 2008, to a tertiary care centre in eastern 
      Nepal. Final diagnosis, risk factors, educational status, time delays, treatment 
      and in-hospital outcomes were evaluated. RESULTS: A total of 153 patients with 
      ACS were admitted in 2008: 58 with ST elevation myocardial infarction (STEMI) 
      (38%), 28 with non-ST elevation myocardial infarction (NSTEMI) (18%) and 67 with 
      unstable angina (UA) (44%). 40% of patients with STEMI presented within 12 hours 
      of symptom onset. Most patients presented late and 33% of them presented after 2 
      days or more. Over half the patients were not literate. Due to the unavailability 
      of percutaneous coronary intervention (PCI) at the centre, thrombolysis with 
      Streptokinase was considered for patients presenting with STEMI up to 24 hours 
      after symptom onset. However, due to financial constraints, only 53% of patients 
      in this broadened time window actually received thrombolytic treatment. The 
      in-hospital mortality was 14% for all patients with ACS, and 17% for the patients 
      with STEMI. CONCLUSIONS: Only a small proportion of patients with ACS in Eastern 
      Nepal are admitted to hospital, and those who are often arrive late, or cannot 
      afford optimal medical management. Awareness, better referral and transport 
      facilities, financial support for the needy, and the availability of on-site 
      coronary angiography and angioplasty for selected patients should contribute to 
      treat more ACS patients and improve their prognosis.
FAU - Shreshta, Nikesh Raj
AU  - Shreshta NR
AD  - Department of Cardiology, BP Koirala Institute of Health Sciences, Dharan, Nepal.
FAU - Basnet, Sandeep
AU  - Basnet S
FAU - Bhandari, Rupak
AU  - Bhandari R
FAU - Acharia, Pramod
AU  - Acharia P
FAU - Karki, Prahlad
AU  - Karki P
FAU - Pilgrim, Thomas
AU  - Pilgrim T
FAU - Meier, Bernhard
AU  - Meier B
FAU - Urban, Philip
AU  - Urban P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110413
PL  - Switzerland
TA  - Swiss Med Wkly
JT  - Swiss medical weekly
JID - 100970884
SB  - IM
MH  - *Acute Coronary Syndrome/diagnosis/drug therapy/etiology/physiopathology
MH  - Aged
MH  - Critical Care
MH  - Cross-Sectional Studies
MH  - Female
MH  - Health Behavior
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nepal
MH  - *Outcome Assessment, Health Care
MH  - Risk Factors
EDAT- 2011/04/15 06:00
MHDA- 2011/07/30 06:00
CRDT- 2011/04/15 06:00
PHST- 2011/04/15 06:00 [entrez]
PHST- 2011/04/15 06:00 [pubmed]
PHST- 2011/07/30 06:00 [medline]
AID - smw-13174 [pii]
AID - 10.4414/smw.2011.13174 [doi]
PST - epublish
SO  - Swiss Med Wkly. 2011 Apr 13;141:w13174. doi: 10.4414/smw.2011.13174. eCollection 
      2011.