Retrospective Analysis of the Epidemiological and Clinical Characteristics of Acute Coronary Syndrome in a Tertiary Hospital Located at High Altitude.

Background

Cardiovascular diseases (CVDs) are the leading global cause of death, responsible for 17.9 million deaths annually (32%) as of 2019. Acute coronary syndrome (ACS) significantly contributes to this burden, particularly in low- and middle-income countries. In Latin America, ACS accounts for 35% of deaths. In Ecuador, 36,058 deaths were reported between 2019 and 2021, underscoring its significant public health impact.

Objectives

This study aimed to determine the epidemiological, clinical, and hospital management characteristics of ACS patients admitted to the Metropolitan Hospital of Quito, located at high altitude, from January 2021 to October 2023. Methodology: A retrospective observational study analyzed anonymized medical records of 133 ACS patients treated at a tertiary care hospital in Quito.

Results

Among 133 ACS patients, 72.9% were male, with a mean age of 68.9 ± 13.9 years. Overweight was prevalent, with a mean BMI of 26.6 ± 3.0 kg/m2. Hypertension (51.9%) and type 2 diabetes mellitus (26.3%) were common comorbidities. ST-segment elevation myocardial infarction (STEMI) was the most frequent ACS type (48.9%), followed by non-ST-segment elevation myocardial infarction (NSTEMI) (33.8%). Most patients (72.2%) underwent stent placement. Mortality was low (2.3%) and significantly associated with the presence of immunologic diseases (p = 0.015), TIMI risk score Grade IV (p = 0.009), and cardiac arrest on admission (p < 0.001).

Conclusions

This study provides critical insights into the epidemiology and management of ACS in a high-altitude urban setting, emphasizing the importance of timely diagnosis and evidence-based therapies in improving patient outcomes.