Acute Coronary Syndrome in Mashhad, Northeastern of Iran: Report of a Decade

Abstract

Background: Acute coronary syndrome (ACS) is a major cause of morbidity and mortality all over the world. Despite substantial efforts that have been made over the last decades, ACS management still remains challenging in most of the regions. Objectives: This study describes the characteristics and trends of outcomes for ACS patients in a decade in north-east of Iran. Methods: In this cross-sectional study, two tertiary academic hospitals of Mashhad University of Medical Sciences in Iran were investigated during a 10-year period starting from January 1, 2007. Patients were identified according to their final diagnosis at discharge using the international classification of diseases 10th revision (ICD-10). The ten-year trend of prevalence of ACS was plotted. The outcomes (alive, death) were compared between the two types of myocardial infarction (MI) (ST-elevation myocardial infarction (STEMI), and non-ST elevation myocardial infarction (NSTEMI)/unspecific). Results: During the study period, there were a total of 9068 admissions for acute MI or unstable angina. The mean age of admitted patients was 61.6 ± 13.7 years and the majority (67.8%) was male. The in-hospital mortality rate was 12.3% (927), which was significantly higher in NSTEMI/unspecific AMI compared to STEMI patients (15.3% vs. 9.8%, P < 0.001). Females were significantly older than males (65.7 ± 12.5 vs. 59.6 ± 13.8, P < 0.001) and have higher mortality rates compared to males (16.7 vs. 10.1, P < 0.001). The prevalence rate of all MI categories had an increasing secular trend, though the mortality rate was decreased. Conclusions: Although the prevalence rate of AMI has slightly increased, the mortality rate has decreased. Close cooperation between general practitioners, health providers and cardiologists are of great importance in this field.