Shahid Gangalal National Heart Centre-ST-elevation Myocardial infarction Registry (SGNHC-STEMI-Registry), Nepal

  • Chandra Mani Adhikari Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal. https://orcid.org/0000-0001-5811-9977
  • Kiran Prasad Acharya Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Reeju Manandhar Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Kunjang Sherpa Department of Cardiology, National Academy of Medical Sciences, Kathmandu, Nepal.
  • Rikesh Tamrakar Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Amrit Bogati Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Satish Kumar Singh Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Subodh Kansakar Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Dharma Nath Yadav Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Murari Dhungana Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Sachin Dhungel Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Bibek Baniya Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Surakshya Joshi Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Sujeeb Rajbhandari Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Rabindra Pandey Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Roshan Raut Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Dipanker Prajapati Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Sanjay Singh KC Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Jagat Adhikari Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Ajay Adhikari Department of Cardiology, National Academy of Medical Sciences, Kathmandu, Nepal.
  • Binayak Gautam Department of Cardiology, National Academy of Medical Sciences, Kathmandu, Nepal.
  • Shaneez Najmy Department of Cardiology, National Academy of Medical Sciences, Kathmandu, Nepal.
  • Rajan Poudel Department of Cardiology, National Academy of Medical Sciences, Kathmandu, Nepal.
  • Birat Krishna Timalsina Department of Cardiology, National Academy of Medical Sciences, Kathmandu, Nepal.
  • Parag Karki Department of Cardiology, National Academy of Medical Sciences, Kathmandu, Nepal.
  • Samir Poudel Department of Cardiology, National Academy of Medical Sciences, Kathmandu, Nepal.
  • Kartikesh Kumar Thakur Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Deepak Limbu Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Himanshu Prasad Nepal Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Mukunda Sharma Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Binay Kumar Rauniyar Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Rajib Rajbhandari Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Yuba Raj Limbu Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Arun Maskey Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Rabi Malla Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Deewakar Sharma Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  • Man Bahadur KC Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
Keywords: Nepal, Primary PCI, STEMI Registry, Thrombolysis

Abstract

Background and Aims: Incidence of ST-elevation myocardial infarction (STEMI) is increasing in Nepal. We aim to describe the presentation, management, complications, and outcomes of patients admitted with a diagnosis of STEMI in Shahid Gangalal National Heart Centre (SGNHC), Nepal.

Methods: Shahid Gangalal National Heart Centre-ST-elevation registry (SGNHC-STEMI) registry was a cross sectional, observational, registry. All the patients who were admitted with the diagnosis of STEMI from January 2018 to December 2018 were included.

Results: In this registry, 1460 patients out of 1486 patients who attended emergency were included. The mean age of patients was 60.8±13.4 years (range: 20 years to 98 years) with 70.3% male patients. Most of the patients (83.2%) were referred from other hospitals and 16.8% of patients directly attended the SGNHC emergency. During the presentation, smoking (54%) was the most common risk factor, followed by hypertension (36.6%), diabetes mellitus (25.3%), and dyslipidemia (7.8%). After admission, new cases of dyslipidemia, HTN, Impaired Fasting Glucose (IFG), and Type 2 DM were diagnosed in 682 (51.3%), 182 (20.1%), 148 (10.3%) and 95 (8.9%) respectively. At the time of presentation, 73.3% were in Killip class I and 26.3% were above Killip class II with 5.1% in cardiogenic shock. Thirty-one percent of the cases received reperfusion therapy (Primary percutaneous intervention in 25.2% and fibrinolysis in 5.8%). Inferior wall MI was the most common type of STEMI. Among the patients who underwent invasive therapy, the multi-vessel disease was noted in 46.2% cases and left main coronary artery involvement in 0.7% cases. In-hospital mortality was 6.2% with cardiogenic shock being the most common cause. Aspirin (97.8%), clopidogrel (96.2%), statin (96.4%), ACEI/ARB (76.8%) and beta-blocker (76.8%) were prescribed during discharge.

Conclusion: The SGNHC-STEMI registry provides valuable information on the overall aspect of STEMI in Nepal. In general, the SGNHC-STEMI registry findings are consistent with other international data.

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Abstract
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Published
2020-05-06
How to Cite
Adhikari, C., Acharya, K., Manandhar, R., Sherpa, K., Tamrakar, R., Bogati, A., Singh, S., Kansakar, S., Yadav, D., Dhungana, M., Dhungel, S., Baniya, B., Joshi, S., Rajbhandari, S., Pandey, R., Raut, R., Prajapati, D., KC, S., Adhikari, J., Adhikari, A., Gautam, B., Najmy, S., Poudel, R., Timalsina, B., Karki, P., Poudel, S., Thakur, K., Limbu, D., Nepal, H., Sharma, M., Rauniyar, B., Rajbhandari, R., Limbu, Y., Maskey, A., Malla, R., Sharma, D., & KC, M. (2020). Shahid Gangalal National Heart Centre-ST-elevation Myocardial infarction Registry (SGNHC-STEMI-Registry), Nepal. Nepalese Heart Journal, 17(1), 7-16. https://doi.org/10.3126/njh.v17i1.28795
Section
Original Articles