Background: Little is known about characteristics at admission and mid-term outcomes of patients with coronary heart disease (CHD) in a resource-limited South-East Asian setting. We aimed to provide a detailed description of characteristics at hospital admission of patients hospitalized with CHD from a poor setting of Indonesian population and of their clinical outcomes at 30-day and 6-month follow-up.
Methods: We performed a cohort study of 477 patients diagnosed with CHD (acute coronary syndrome and stable coronary artery disease) admitted at the Makassar Cardiac Center, Indonesia, between February 2013 and December 2014. The outcomes, obtained by active follow-up, were all-cause mortality and major adverse cardiovascular events (MACE).
Results: Out of 477 CHD patients, the proportion of young age (<60 years) was 53.9% and 72.7% were male. At admission, 44.2% of patients were diagnosed with ST-elevation myocardial infarction (STEMI), 38.6% with diagnosis or signs of heart failure, and 75.1% had previous hypertension. Out of 211 STEMI patients, only 4.7% had been treated by primary PCI and 6.2% received thrombolysis. The time lapse from symptom onset to hospital admission was 26.8 hours (IQR 10.0-48.0), and only 20.1% of all patients had undergone either PCI or CABG. The survival rate at 6 months was 78.9%. The rates of all-cause mortality in hospital, at 30 days, and 6 months were 10.9%, 2.5%, and 7.3%, respectively; the rate of MACE at 30 days was 14.9% and at 6 months was 17.8%.
Conclusions: Patients with CHD in a resource-limited Indonesian setting are predominantly young males, present late after chest pain onset, and rarely receive guideline-recommended therapy. During 6-month follow-up, more than a third of these CHD patients have adverse clinical outcomes.