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ORIGINAL ARTICLE
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Volume 23	July - September 2007	Number  4
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Profile of Acute Myocardial Infarction
(AMI) In Pakistan

Maqbool H. Jafary¹, Abdus Samad², Mohammad Ishaq³,
Shaukat Ali Jawaid⁴,Mansoor Ahmad⁵, Ejaz Ahmad Vohra⁶

On behalf of AAUS** Study Group of Pakistan Aspirin Foundation, Karachi, Pakistan

ABSTRACT

Objective: While doing the study on Aspirin Awareness and Usage (AAUS) in cases of Acute Coronary Syndrome (ACS), AAUS study Group designed the protocol to include the profile of patients presenting with symptoms of ACS and in the light of that also reviewed the available data in South Asian population.

Methodology: A prospective study was carried out in 17 coronary care units (CCUs) in all 4 provinces of Pakistan. Patients included were males and females of all age groups presenting with chest pain, diagnosed to have Coronary Artery Disease (CAD) and categorized into Unstable Angina (USA), STEMI or NSTEMI, based on clinical, ECG and enzymatic criteria. The risk factors, family history, dietary history, time to reach ER after the onset of symptoms, management of ACS in CCU and outcome of treatment were recorded.

Results: A total of 1,527 patients presented to the Emergency Room (ER) with chest pain but around 1400 patients were evaluable. The majority (68%) were males. The mean age of all patients was 52.2±10.7 years. 28.3% patients were <45 years. Average time to presentation at ER was 13.2±6.2 hours. 92.7% patients presented with chest pain. More than half the patients had hypertension (55.2%) and or smoking (52%) as the risk factors while 37.2 % had diabetes and 18.2% had hyperlipidemia. Hypertension (52.7%), IHD (44%) and Diabetes (36.2%) figured prominently in the family history. USA and STEMI were the major types of ACS (43.0% and 40.5% respectively). At discharge 67.8% of patients were stable without symptoms, 13.3% were stable but with symptoms, 16.4% were referred for further investigations and 2.5% had died.

Conclusions: The review of the available data in Pakistan, supported by the present study in a cohort of 1400 patients from 17 CCUs in the country, the emerging profile of patients with AMI is that the majority are male, relatively younger as compared to Western population, have smoking and hypertension followed by diabetes as the major risk factors. USA and STEMI are the dominant types of ACS and the majority of patients are likely to have hypertension, IHD and diabetes in their families. Better control of risk factors and the awareness of preventive strategies are needed.

KEY WORDS: Acute Coronary Syndrome (ACS), Acute Myocardial Infarction (AMI), Risk factors, Ischaemic Heart Disease, Profile.

Pak J Med Sci   July - September 2007   Vol. 23 No. 4   485-489

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1. Dr. Maqbool H Jafary FRCP
Consultant Cardiologist
Karachi Institute of Heart Diseases
and Midciti Hospital,
Karachi – Pakistan.
2. Prof. Abdus Samad MD
Karachi Institute of Heart Diseases,
Karachi – Pakistan.
3. Prof. Mohammad Ishaq FRCP
National Institute of Cardiovascular Diseases,
Karachi – Pakistan.
4. Mr. Shaukat Ali Jawaid
Chief Editor,
Pulse International,
Karachi – Pakistan.
5. Prof. Mansoor Ahmad FRCP
Liaquat National Hospital,
Karachi – Pakistan.
6. Prof. Ejaz Ahmad Vohra FRCP,
Ziauddin Medical University
Karachi. Pakistan.

Correspondence:

1. Dr. Maqbool H. Jafary, FRCP
Consultant Cardiologist,
KIHD and Midciti Hospital,
Karachi - Pakistan.
E mail: drjafary@gmail.com

2-6: Affiliation of authors see page 489

* Received for Publication: May 8, 2007.
* Accepted: June 20, 2007
** Aspirin Awareness & Usage Study (AAUS)

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