Evaluation of Clinical and Demographic Characteristics According to Acute Coronary Syndrome Subtypes

Öz

Objective: Acute coronary syndromes are a group of life-threatening conditions frequently encountered in emergency departments. However, the clinical and demographic characteristics of these syndromes according to their subtypes have not been thoroughly investigated. This study examined possible differences in the clinical and demographic characteristics of ACS subtypes. Material and Method: The study included 252 consecutive patients presenting with ACS (NSTE-ACS and STEMI). Study data were obtained using a pre-prepared online case report form. The data were statistically evaluated in terms of clinical and demographic characteristics according to ACS type. Results: A total of 252 ACS patients (177 men and 75 women with a mean age of 63.2 ± 12.2 years) were included in the study. The prevalence of hypertension, hyperlipidaemia, diabetes and active smoking was 47.2%, 33.3%, 33.7% and 41.3%, respectively. At the time of admission, 40.5% of cases were diagnosed as STEMI and 59.5% as NSTE-ACS. The most common method of admission was by private vehicle (57.1%), while 31% were admitted by ambulance. Forty-five point two per cent of patients had a family history of coronary artery disease, and 23.8 per cent had undergone a cardiology clinic check-up in the past three months. A history of coronary artery bypass grafting (10.7%), stenting (34.1%) and pacemaker implantation (3.2%) was identified. Angiography was performed on 225 patients prior to discharge. Stenting was planned for 76.2% of patients, coronary artery bypass grafting (CABG) for 3.2%, and medical treatment for 11.5%. In the NSTE-ACS group, the rates of two- to three-vessel disease and CABG/medical treatment were significantly higher than in the STEMI group (p < 0.001). Male gender predominated in both groups. Conclusion: Our study found that there were some differences in clinical characteristics between STEMI and NSTEMI cases, and our results were consistent with those reported in the literature.

Anahtar Kelimeler

• Acute Coronary Syndrome
• Myocardial Infarction
• Coronary Angiography

Akut Koroner Sendrom Alt Tiplerine Göre Klinik ve Demografik Özelliklerin Değerlendirilmesi

Öz

Amaç: Akut koroner sendromlar acil servislerde sıklıkla karşılaşılan ve yaşamı tehdit eden bir sendrom grubudur. Akut koroner sendromların klinik ve demografik özellikleri, tiplerine göre ayrıntılı olarak incelenmemiştir. Bu çalışmada, ACS tipleri arasındaki olası klinik ve demografik farklılıkları inceledik. Yöntem ve Gereç: Çalışmamıza ACS (NSTE-ACS ve STEMI) ile başvuran 252 ardışık hasta dahil edildi. Çalışma verileri, çevrimiçi olarak uygulanan önceden hazırlanmış bir vaka rapor formu kullanılarak elde edildi. Veriler, ACS tipine göre klinik ve demografik özellikler açısından istatistiksel olarak değerlendirildi. Bulgular: Çalışmaya toplam 252 AKS hastası (177 erkek, 75 kadın; ort. yaş 63,2±12,2 yıl) dahil edildi. Hastaların %47,2’sinde hipertansiyon, %33,3’ünde hiperlipidemi, %33,7’sinde diyabet ve %41,3’ünde aktif sigara kullanımı mevcuttu. Başvuru anında olguların %40,5’i STEMI, %59,5’i NSTE-AKS tanısı almıştı. En sık başvuru yöntemi özel araç (%57,1) iken, %31’i ambulansla gelmişti. %45,2 oranında ailevi KAH öyküsü, %23,8 oranında ise son 3 ayda kardiyoloji polikliniği kontrolü mevcuttu. Önceden KABG (%10,7), stent (%34,1) ve kalp pili (%3,2) öyküleri saptandı. Taburculuk öncesi 225 hastaya anjiyografi uygulanmış olup, %76,2’sine stent, %3,2’sine KABG, %11,5’ine medikal tedavi planlandı. NSTE-AKS grubunda 2-3 damar hastalığı ve KABG/medikal tedavi oranları STEMI grubuna göre anlamlı olarak daha yüksekti (p<0,001). Her iki grupta da erkek cinsiyet baskındı. Sonuç: Çalışmamızda STEMI ve NSTEMI vakaları klinik özellikler açısından aralarında bazı farklılıkların olduğu ve çalışmamızın sonuçlarının literatür ile uyumlu sonuçlar elde edilmiştir.

Anahtar Kelimeler

• AKUT KORONER SENDROM
• Miyokard İnfarktüsü
• koroner anjiyografi

Kaynakça

1. Lindstrom M, DeCleene N, Dorsey H, Fuster V, Johnson CO, LeGrand KE, et al. Global burden of cardiovascular diseases and risks collaboration, 1990-2021. Journal of the American College of Cardiology. 2022;80(25):2372-425.
2. Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42(14):1289-367.
3. Falk E, Nakano M, Bentzon JF, Finn AV, Virmani R. Update on acute coronary syndromes: the pathologists’ view. European heart journal. 2013;34(10):719-28.
4. Domienik-Karłowicz J, Kupczyńska K, Michalski B, Kapłon-Cieślicka A, Darocha S, Dobrowolski P, et al. Fourth universal definition of myocardial infarction. Selected messages from the European Society of Cardiology document and lessons learned from the new guidelines on ST-segment elevation myocardial infarction and non-ST-segment elevation-acute coronary syndrome. Cardiology journal. 2021;28(2):195-201.
5. Rao SV, O’Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025;151(13):e771-e862.
6. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes: Developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). European Heart Journal. 2023;44(38):3720-826.
7. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73(24):3168-209.
8. Mehta SR, Bossard M. Acute Coronary Syndromes and Multivessel Disease: Completing the Evidence. JACC Cardiovasc Interv. 2020;13(13):1568-70.

9. Singh A, Museedi AS, Grossman SA. Acute Coronary Syndrome. StatPearls. Treasure Island (FL): StatPearls Publishing, Copyright © 2025, StatPearls Publishing LLC.; 2025.
10. Krishnamurthy SN, Pocock S, Kaul P, Owen R, Goodman SG, Granger CB, et al. Comparing the long-term outcomes in chronic coronary syndrome patients with prior ST-segment and non-ST-segment elevation myocardial infarction: findings from the TIGRIS registry. BMJ Open. 2023;13(12):e070237.
11. Roston TM, Aghanya V, Savu A, Fordyce CB, Lawler PR, Jentzer J, et al. Premature Acute Myocardial Infarction Treated With Invasive Revascularization: Comparing STEMI With NSTEMI in a Population-Based Study of Young Patients. Canadian Journal of Cardiology. 2024;40(11):2079-88.
12. Işık F, İnci Ü, Akyüz A, Cil H. ST Segment Yükselmesiz Akut Koroner Sendromlu Yaşlı Hastalarda Girişimsel Tedavi ile Konservatif Tedavinin Altı Aylık Dönemde Mortalite Üzerine Etkilerinin Karşılaştırılması. Dicle Tıp Dergisi. 2021;48(3):529-36.
13. Gandhi S, Garratt KN, Li S, Wang TY, Bhatt DL, Davis LL, et al. Ten-Year Trends in Patient Characteristics, Treatments, and Outcomes in Myocardial Infarction From National Cardiovascular Data Registry Chest Pain-MI Registry. Circ Cardiovasc Qual Outcomes. 2022;15(1):e008112.
14. Kim YH, Her A-Y, Rha S-W, Choi CU, Choi BG, Park S, et al. Comparison of Outcomes Between ST-Segment Elevation and Non-ST-Segment Elevation Myocardial Infarctions Based on Left Ventricular Ejection Fraction. Journal of Clinical Medicine. 2024;13(22):6744.
15. Tziakas D, Chalikias G, Al-Lamee R, Kaski JC. Total coronary occlusion in non ST elevation myocardial infarction: Time to change our practice? International Journal of Cardiology. 2021;329:1-8.
16. Figtree GA, Vernon ST, Hadziosmanovic N, Sundström J, Alfredsson J, Nicholls SJ, et al. Mortality and Cardiovascular Outcomes in Patients Presenting With Non-ST Elevation Myocardial Infarction Despite No Standard Modifiable Risk Factors: Results From the SWEDEHEART Registry. J Am Heart Assoc. 2022;11(15):e024818.