Clinical Characteristics and Outcomes of Acute Coronary Syndrome in a Group of patients in Slemani Cardiac Hospital

Abstract

Background: Acute coronary syndrome (ACS) is a subcategory of coronary artery disease (CAD) that encompasses a range of thrombotic cardiovascular events and remains a significant cause of morbidity and mortality worldwide. The clinical characteristics and outcomes of ACS patients can vary significantly based on geographical location, healthcare facilities, and population demographics. These variations highlight the importance of region-specific studies to better understand the presentation, management, and outcomes of ACS in diverse populations. Aim: This study aimed to evaluate the demographic profile, cardiovascular risk factors, seasonal variations, clinical presentations, and in-hospital outcomes of ACS patients admitted to Slemani Cardiac Hospital. Methods: A retrospective cross-sectional study was conducted on 375 ACS patients admitted between June 2021 and January 2022. Data on demographics, comorbidities, lifestyle risk factors, past cardiovascular history, ACS subtype, seasonal variation, management, and complications were collected from medical records and analyzed using SPSS. Results: The mean age was 63.3 ± 6.7 years, with a 60% male predominance. Hypertension (57.3%) was the most common risk factor, followed by diabetes mellitus (43.2%), smoking (31.7%), and prior coronary artery disease (29.9%). Unstable angina was the most frequent presentation (51.2%), followed by STEMI (27.7%) and NSTEMI (21.1%). Younger patients (48–57 years) were more likely to present with STEMI, while NSTEMI predominated in older groups (70–78 years). ACS admissions were significantly higher in winter than in summer (p = 0.030), with notable seasonal differences in risk factor distribution. Coronary angiography was performed in 24.8% of cases, PCI in 16%, and CABG in 2.9%. The most common complication was heart failure (20%), with STEMI associated with higher rates of arrhythmia, cardiogenic shock, stroke, and in-hospital mortality (25% within the STEMI group). Conclusions: ACS in this region predominantly affects older males, with hypertension and diabetes as the leading modifiable risk factors. Seasonal variation influences ACS incidence, with higher rates in winter. Tailored prevention strategies—particularly targeting blood pressure control, diabetes management, and smoking cessation—are essential to reduce the ACS burden.