Retrospective Analysis of the Epidemiological and Clinical Characteristics of Acute Coronary Syndrome in a Tertiary Hospital Located at High Altitude
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Desing
2.2. Setting
2.3. Sample
2.4. Inclusion and Exclusion Criteria
2.5. Sample and Data Collection
2.6. Statistical Analysis
2.7. Ethical Statement
3. Results
3.1. Demographic Characteristics and Personal History
3.2. Characteristics of Acute Coronary Syndrome
3.3. Admission and Hospital Management
3.4. Factors Related to Mortality
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CVDs | cardiovascular diseases |
ACS | acute coronary syndrome |
DALYs: | disability-adjusted life years |
STEMI | ST-segment elevation myocardial infarction |
NSTEMI | Non-ST-segment elevation myocardial infarction |
WHO | World Health Organization |
IHD | ischemic heart disease |
References
- WHO Cardiovascular diseases (CVDs). World Health Organization. Available online: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (accessed on 12 April 2025).
- Ortiz-Prado, E.; Izquierdo-Condoy, J.S.; Fernández-Naranjo, R.; Vásconez-González, J.; Cano, L.; González, A.C.; Morales-Lapo, E.; Guerrero-Castillo, G.S.; Duque, E.; Rosero, M.G.D.; et al. Epidemiological characterization of ischemic heart disease at different altitudes: A nationwide population-based analysis from 2011 to 2021 in Ecuador. PLoS ONE 2023, 18, e0295586. [Google Scholar] [CrossRef]
- Kumar, A.; Cannon, C.P. Acute coronary syndromes: Diagnosis and management, part I. Mayo Clin. Proc. 2009, 84, 917–938. [Google Scholar]
- Singh, A.; Museedi, A.S.; Grossman, S.A. Acute Coronary Syndrome. In StatPearls; StatPearls Publishing: Treasure Island, FL, USA, 2025. Available online: http://www.ncbi.nlm.nih.gov/books/NBK459157/ (accessed on 12 April 2025).
- Bergmark, B.A.; Mathenge, N.; Merlini, P.A.; Lawrence-Wright, M.B.; Giugliano, R.P. Acute coronary syndromes. Lancet 2022, 399, 1347–1358. [Google Scholar] [CrossRef]
- Ralapanawa, U.; Sivakanesan, R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. J. Epidemiol. Glob. Health 2021, 11, 169–177. [Google Scholar] [CrossRef] [PubMed]
- Vedanthan, R.; Seligman, B.; Fuster, V. Global perspective on acute coronary syndrome: A burden on the young and poor. Circ. Res. 2014, 114, 1959–1975. [Google Scholar] [CrossRef] [PubMed]
- Hernández-Leiva, E. Epidemiology of acute coronary syndrome and heart failure in Latin America. Rev. Esp. Cardiol. 2011, 64 (Suppl. S2), 34–43. [Google Scholar] [CrossRef]
- Espinosa-Yépez, K.R.; García-Cevallos, M.P. Infarto agudo de miocardio en Ecuador: Carga de la enfermedad y distribución geográfica. Metro Cienc. 2023, 31, 18–27. [Google Scholar] [CrossRef]
- Macovei, L.; Macovei, C.M.; Macovei, D.C. Coronary Syndromes and High-Altitude Exposure—A Comprehensive Review. Diagnostics 2023, 13, 1317. [Google Scholar] [CrossRef]
- Bonadei, I.; Sciatti, E.; Vizzardi, E.; Berlendis, M.; Bozzola, G.; Metra, M. Coronary Artery Disease and High Altitude: Unresolved Issues. Res. Cardiovasc. Med. 2016, 5, e32645. [Google Scholar] [PubMed]
- Chacón-Diaz, M. Chronic exposure to high altitude and the presence of coronary ectasia in patients with ST elevation myocardial infarction. Arch. Peru. Cardiol. Cir. Cardiovasc. 2023, 4, 151–156. [Google Scholar]
- Chauhan, R.; Prasad, K.; Vemuri, K.S.; Kumar, R.M. Triple Whammy: Concurrent High-Altitude Exposure and COVID-19 Infection Presenting With STEMI. Indian J. Clin. Cardiol. 2021, 2, 142–145. [Google Scholar] [CrossRef]
- Hutchison, S.J.; Litch, J.A. Acute myocardial infarction at high altitude. JAMA 1997, 278, 1661–1662. [Google Scholar] [CrossRef] [PubMed]
- Wang, J.; Yan, C.-Y.; Wang, W.; Wang, T.-Z. Preventive Effect of Moderate Altitude on Non-Culprit Lesion Progression in Patients with Acute Myocardial Infarction. High Alt. Med. Biol. 2022, 23, 345–351. [Google Scholar] [CrossRef]
- Savonitto, S.; Piatti, L.; Tiberti, G. Two Myocardial Infarctions and Five 8,000-m Peaks. Am. J. Cardiol. 2023, 209, 8–9. [Google Scholar] [CrossRef] [PubMed]
- Al-Huthi, M.A.; Ahmed Raja’a, Y.; Al-Noami, M.; Rahman, A.R.A. Prevalence of Coronary Risk Factors, Clinical Presentation, and Complications in Acute Coronary Syndrome Patients Living at High vs Low Altitudes in Yemen. MedGenMed 2006, 8, 28. [Google Scholar]
- Mauriello, A.; Ascrizzi, A.; Molinari, R.; Falco, L.; Caturano, A.; D’Andrea, A.; Russo, V. Pharmacogenomics of Cardiovascular Drugs for Atherothrombotic, Thromboembolic and Atherosclerotic Risk. Genes 2023, 14, 2057. [Google Scholar] [CrossRef] [PubMed]
- Björck, L.; Nielsen, S.; Jernberg, T.; Zverkova-Sandström, T.; Giang, K.W.; Rosengren, A. Absence of chest pain and long-term mortality in patients with acute myocardial infarction. Open Heart 2018, 5, e000909. [Google Scholar] [CrossRef]
- Brieger, D.; Eagle, K.A.; Goodman, S.G.; Steg, P.G.; Budaj, A.; White, K.; Montalescot, G.; GRACE Investigators. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: Insights from the Global Registry of Acute Coronary Events. Chest 2004, 126, 461–469. [Google Scholar] [CrossRef]
- Canto, J.G.; Shlipak, M.G.; Rogers, W.J.; Malmgren, J.A.; Frederick, P.D.; Lambrew, C.T.; Ornato, J.P.; Barron, H.V.; Kiefe, C.I. Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. JAMA 2000, 283, 3223–3229. [Google Scholar] [CrossRef]
- Rogers, W.J.; Frederick, P.D.; Stoehr, E.; Canto, J.G.; Ornato, J.P.; Gibson, C.M.; Pollack, C.V.; Gore, J.M.; Chandra-Strobos, N.; Peterson, E.D.; et al. Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. Am. Heart J. 2008, 156, 1026–1034. [Google Scholar] [CrossRef]
- Trimarchi, G.; Pizzino, F.; Lilli, A.; De Caterina, A.R.; Esposito, A.; Dalmiani, S.; Mazzone, A.; Di Bella, G.; Berti, S.; Paradossi, U. Advanced Lung Cancer Inflammation Index as Predictor of All-Cause Mortality in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention. J. Clin. Med. 2024, 13, 6059. [Google Scholar] [CrossRef] [PubMed]
- Gao, Y.; Li, Y.; Chen, X.; Wu, C.; Guo, Z.; Bai, G.; Liu, T.; Li, G. The Systemic Inflammation Index Predicts Poor Clinical Prognosis in Patients with Initially Diagnosed Acute Coronary Syndrome Undergoing Primary Coronary Angiography. J. Inflamm. Res. 2023, 16, 5205–5219. [Google Scholar] [CrossRef] [PubMed]
- Chacornac, M.; Baronne-Rochette, G.; Schmidt, M.-H.; Savary, D.; Habold, D.; Bouvaist, H.; Marliere, S.; Belle, L.; Machecourt, J.; Vanzetto, G.; et al. Characteristics and management of acute ST-segment elevation myocardial infarctions occurring in ski resorts in the French Alps: Impact of an acute coronary care network. Arch. Cardiovasc. Dis. 2010, 103, 460–468. [Google Scholar] [CrossRef] [PubMed]
Outcome | p-Value | |||||||
---|---|---|---|---|---|---|---|---|
Total | Alive | Deceased | ||||||
n | % | n | % | n | % | |||
Sex | Male | 97 | 72.9 | 95 | 97.9 | 2 | 2.1 | 0.805 |
Female | 36 | 27.1 | 35 | 97.2 | 1 | 2.8 | ||
Residence | Ecuador | 130 | 97.7 | 127 | 97.7 | 3 | 2.3 | 0.790 |
Foreign | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | ||
Age (years) | Mean (±SD) | 68.9 | 13.9 | 68.6 | 14.1 | 68.3 | 4.2 | 0.971 * |
Ethnicity | White | 7 | 5.3 | 7 | 100.0 | 0 | 0.0 | 0.680 |
Mestizo | 126 | 94.7 | 123 | 97.6 | 3 | 2.4 | ||
BMI (kg/m2) | Mean (±SD) | 26.6 | 3.4 | 27.4 | 3.1 | 23.6 | 1.6 | 0.051 * |
Alcohol Consumption | Yes | 10 | 7.5 | 10 | 100.0 | 0 | 0.0 | 0.617 |
Smoking | Yes | 34 | 25.6 | 34 | 100.0 | 0 | 0.0 | 0.305 |
Hospitalization for Same Cause (30 Days) | Yes | 4 | 3 | 4 | 100.0 | 0 | 0.0 | 0.758 |
Physical Activity (3 times a week) | Yes | 35 | 26.3 | 35 | 100.0 | 0 | 0.0 | 0.295 |
Medical History | ||||||||
History of Cardiac Surgery | Yes | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | 0.790 |
Type of Surgery | None | 130 | 97.7 | 127 | 97.7 | 3 | 2.3 | 0.965 |
Valvular | 1 | 0.8 | 1 | 100.0 | 0 | 0.0 | ||
Coronary | 2 | 1.5 | 2 | 100.0 | 0 | 0.0 | ||
Myocardial Infarction (MI) | Yes | 31 | 23.3 | 29 | 93.5 | 2 | 6.5 | 0.072 |
Hypertension | Yes | 69 | 51.9 | 67 | 97.1 | 2 | 2.9 | 0.604 |
Type 2 Diabetes | Yes | 35 | 26.3 | 33 | 94.3 | 2 | 5.7 | 0.108 |
Dyslipidemia | Yes | 25 | 18.8 | 24 | 96.0 | 1 | 4.0 | 0.515 |
History of PE, DVT, or Stroke | Yes | 10 | 7.5 | 10 | 100.0 | 0 | 0.0 | 0.617 |
Obesity | Yes | 30 | 22.6 | 30 | 100.0 | 0 | 0.0 | 0.344 |
Chronic Kidney Disease | Yes | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | 0.790 |
Thyroid Disease | Yes | 17 | 12.8 | 17 | 100.0 | 0 | 0.0 | 0.502 |
Chagas Serology | Yes | 1 | 0.8 | 1 | 100.0 | 0 | 0.0 | 0.879 |
Sleep Apnea | Yes | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | 0.79 |
Use of CPAP | Yes | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | 0.79 |
Immunologic Diseases | Yes | 6 | 4.5 | 5 | 83.3 | 1 | 16.7 | 0.015 |
Heart Failure | Yes | 2 | 1.5 | 2 | 100.0 | 0 | 0.0 | 0.829 |
Arrhythmia | Yes | 5 | 1.5 | 5 | 100.0 | 0 | 0.0 | 0.729 |
Pacemaker Use | Yes | 2 | 1.5 | 2 | 100.0 | 0 | 0.0 | 0.829 |
Prior Use of Defibrillator | No | 133 | 100.0 | 130 | 97.7 | 3 | 2.3 | N/A |
Variable | Men (n = 97) | Alive (n = 95) | Deceased (n = 2) | Women (n = 36) | Alive (n = 35) | Deceased (n = 1) |
---|---|---|---|---|---|---|
Age (years, mean ± SD) | 68.0 ± 14.2 | 68.1 ± 14.3 | 70.0 ± 4.2 | 70.4 ± 12.9 | 70.5 ± 13.1 | 65.0 ± 0.0 |
BMI (kg/m2, mean ± SD) | 26.9 ± 3.1 | 26.9 ± 3.1 | 24.7 ± 1.4 | 26.1 ± 3.8 | 26.2 ± 3.9 | 22.3 ± 0.0 |
Hypertension (%) | 53.6 (52/97) | 54.7 (52/95) | 0.0 (0/2) | 47.2 (17/36) | 48.6 (17/35) | 0.0 (0/1) |
Diabetes (%) | 22.7 (22/97) | 21.1 (20/95) | 100.0 (2/2) | 33.3 (12/36) | 34.3 (12/35) | 0.0 (0/1) |
Dyslipidemia (%) | 16.5 (16/97) | 15.8 (15/95) | 50.0 (1/2) | 25.0 (9/36) | 25.7 (9/35) | 0.0 (0/1) |
Smoking (%) | 32.0 (31/97) | 32.6 (31/95) | 0.0 (0/2) | 13.9 (5/36) | 14.3 (5/35) | 0.0 (0/1) |
Immunologic Disease (%) | 3.1 (3/97) | 2.1 (2/95) | 50.0 (1/2) | 8.3 (3/36) | 8.6 (3/35) | 0.0 (0/1) |
ACS Type: STEMI (%) | 54.6 (53/97) | 54.7 (52/95) | 50.0 (1/2) | 36.1 (13/36) | 37.1 (13/35) | 0.0 (0/1) |
TIMI Grade IV (%) | 10.3 (10/97) | 9.5 (9/95) | 50.0 (1/2) | 5.6 (2/36) | 5.7 (2/35) | 0.0 (0/1) |
Femoral Access (%) | 8.2 (8/97) | 7.4 (7/95) | 50.0 (1/2) | 11.1 (4/36) | 8.6 (3/35) | 100.0 (1/1) |
Stent Placement (%) | 76.3 (74/97) | 76.8 (73/95) | 50.0 (1/2) | 63.9 (23/36) | 65.7 (23/35) | 0.0 (0/1) |
Heart Rate (bpm, mean ± SD) | 77.1 ± 16.5 | 76.7 ± 15.9 | 94.5 ± 35.4 | 80.0 ± 18.1 | 79.8 ± 18.4 | 85.0 ± 0.0 |
Systolic BP (mmHg, mean ± SD) | 130.7 ± 24.3 | 131.2 ± 24.0 | 85.0 ± 49.5 | 125.8 ± 26.7 | 127.8 ± 25.4 | 50.0 ± 0.0 |
Cardiac Arrest (%) | 2.1 (2/97) | 0.0 (0/95) | 100.0 (2/2) | 2.8 (1/36) | 0.0 (0/35) | 100.0 (1/1) |
LVEF (%, mean ± SD) | 53.2 ± 20.1 | 54.0 ± 19.6 | 0.0 ± 0.0 | 48.5 ± 22.8 | 49.9 ± 22.3 | 0.0 ± 0.0 |
Statins (%) | 98.0 (95/97) | 100.0 (95/95) | 0.0 (0/2) | 97.2 (35/36) | 100.0 (35/35) | 0.0 (0/1) |
Beta-blockers (%) | 58.8 (57/97) | 60.0 (57/95) | 0.0 (0/2) | 50.0 (18/36) | 51.4 (18/35) | 0.0 (0/1) |
ASA (%) | 97.9 (95/97) | 100.0 (95/95) | 0.0 (0/2) | 97.2 (35/36) | 100.0 (35/35) | 0.0 (0/1) |
Clopidogrel/Ticagrelor (%) | 83.5 (81/97) | 85.3 (81/95) | 0.0 (0/2) | 75.0 (27/36) | 77.1 (27/35) | 0.0 (0/1) |
Mortality (%) | 2.1 (2/97) | - | - | 2.8 (1/36) | - | - |
Outcome | p-Value | |||||||
---|---|---|---|---|---|---|---|---|
Total | Alive | Deceased | ||||||
n | % | n | % | n | % | |||
Type of ACS | NSTEMI | 45 | 33.8 | 45 | 100.0 | 0 | 0.0 | 0.063 |
STEMI | 65 | 48.9 | 64 | 98.5 | 1 | 1.5 | ||
Unstable Angina | 23 | 17.3 | 21 | 91.3 | 2 | 8.7 | ||
Type of ACS Symptom | Precordial Pain | 114 | 85.7 | 111 | 97.4 | 3 | 2.6 | 0.972 |
Dyspnea | 7 | 5.3 | 7 | 100.0 | 0 | 0.0 | ||
Sincope | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | ||
Palpitaciones | 2 | 1.5 | 2 | 100.0 | 0 | 0.0 | ||
Otros | 7 | 5.3 | 7 | 100.0 | 0 | 0.0 | ||
GRACE Risk Category | High | 42 | 31.6 | 41 | 97.6 | 1 | 2.4 | 0.504 |
Intermediate | 37 | 27.8 | 37 | 100.0 | 0 | 0.0 | ||
Low | 54 | 40.6 | 52 | 96.3 | 2 | 3.7 | ||
TIMI Risk Score | Not Applicable | 12 | 9 | 10 | 83.3 | 2 | 16.7 | 0.009 |
Grade I | 21 | 15.8 | 21 | 100.0 | 0 | 0.0 | ||
Grade II | 28 | 21.1 | 28 | 100.0 | 0 | 0.0 | ||
Grade III | 58 | 43.6 | 58 | 100.0 | 0 | 0.0 | ||
Grade IV | 12 | 9 | 11 | 91.7 | 1 | 8.3 | ||
Coronary Angiography Performed | Yes | 133 | 100.0 | 130 | 97.7 | 3 | 2.3 | |
Coronary Access Route | Radial | 121 | 91 | 120 | 99.2 | 1 | 0.8 | 0.002 |
Femoral | 12 | 9 | 10 | 83.3 | 2 | 16.7 | ||
Affected Coronary Artery | None | 24 | 18 | 23 | 95.8 | 1 | 4.2 | 0.305 |
Left Anterior Descending (LAD) | 50 | 37.6 | 50 | 100.0 | 0 | 0.0 | ||
Right Coronary Artery (RCA) | 27 | 20.3 | 27 | 100.0 | 0 | 0.0 | ||
Circumflex Artery (Cx) | 15 | 11.3 | 14 | 93.3 | 1 | 6.7 | ||
Other | 2 | 1.5 | 2 | 100.0 | 0 | 0.0 | ||
LAD + RCA | 4 | 3 | 4 | 100.0 | 0 | 0.0 | ||
LAD + Cx | 7 | 5.3 | 6 | 85.7 | 1 | 14.3 | ||
RCA + Cx | 4 | 3 | 4 | 100 | 0 | 0 | ||
Stent Placement | No | 37 | 27.8 | 35 | 94.6 | 2 | 5.4 | 0.129 |
Yes | 96 | 72.2 | 95 | 99.0 | 1 | 1.0 | ||
Number of Stents Placed | 0 | 37 | 27.8 | 35 | 94.6 | 2 | 5.4 | 0.377 |
1 | 72 | 54.1 | 72 | 100.0 | 0 | 0.0 | ||
2 | 19 | 14.3 | 18 | 94.7 | 1 | 5.3 | ||
3 | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | ||
4 | 2 | 1.5 | 2 | 100.0 | 0 | 0.0 |
Outcome | p-Value | |||||||
---|---|---|---|---|---|---|---|---|
Total | Alive | Deceased | ||||||
n | % | n | % | n | % | |||
Heart Rate (bpm) | Mean (±SD) | 78 | 17 | 77.4 | 16.7 | 97 | 39.1 | 0.054 |
Systolic Blood Pressure (mmHg) | Mean (±SD) | 129 | 25 | 129.6 | 23.8 | 93.3 | 37.8 | 0.011 * |
Diastolic Blood Pressure (mmHg) | Mean (±SD) | 79 | 16 | 79.1 | 15.5 | 63.3 | 20.8 | 0.086 |
Creatinine (mg/dL) | Mean (±SD) | 1.1 | 0.4 | 1.1 | 0.4 | 0.8 | 0.7 | 0.526 * |
Baseline Glomerular Filtration Rate (eGFR) | Mean (±SD) | 75.13 | 22.08 | 75.21 | 22.17 | 71.67 | 21.13 | 0.785 * |
Hemoglobin (g/dL) | Mean (±SD) | 15.3 | 4.1 | 15.3 | 4.1 | 12.3 | 3.6 | 0.223 * |
Hematocrit (%) | Mean (±SD) | 45.1 | 7.6 | 45.3 | 7.6 | 34.8 | 10.2 | 0.215 * |
Door-to-ECG time (minutes) | Mean (±SD) | 10.8 | 6.0 | 10.8 | 6.1 | 10.0 | 0.0 | 0.166 |
Door-to-balloon time (minutes) | Mean (±SD) | 71.9 | 127.4 | 73.5 | 128.6 | 10.0 | 1.0 | <0.001 * |
Cardiac Arrest on Admission | No | 130 | 97.7 | 130 | 100.0 | 0 | 0.0 | <0.001 * |
Yes | 3 | 2.3 | 0 | 0.0 | 3 | 100.0 | ||
Electrocardiogram Performed | Yes | 133 | 100.0 | 130 | 97.7 | 3 | 2.3 | |
Sinus Rhythm | No | 5 | 3.8 | 5 | 100.0 | 0 | 0.0 | 0.729 |
Yes | 128 | 96.2 | 125 | 97.7 | 3 | 2.3 | ||
Type of Conduction Block | None | 119 | 89.5 | 117 | 98.3 | 2 | 1.7 | 0.196 |
First-Degree AV Block | 5 | 3.8 | 5 | 100.0 | 0 | 0.0 | ||
Right Bundle Branch Block (RBBB) | 6 | 4.5 | 5 | 83.3 | 1 | 16.7 | ||
Left Bundle Branch Block (LBBB) | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | ||
Arrhythmias | None | 119 | 89.5 | 116 | 97.5 | 3 | 2.5 | 0.996 |
Atrial Fibrillation | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | ||
Ventricular Tachycardia | 1 | 0.8 | 1 | 100.0 | 0 | 0.0 | ||
Ventricular Fibrillation | 2 | 1.4 | 2 | 100.0 | 0 | 0.0 | ||
Other | 8 | 6 | 8 | 100.0 | 0 | 0.0 | ||
ST-Segment Elevation | No | 72 | 54.2 | 70 | 97.2 | 2 | 2.8 | 0.892 |
Yes | 61 | 45.9 | 60 | 98.4 | 1 | 1.6 | ||
Pathologic Q Wave | No | 117 | 88 | 114 | 97.4 | 3 | 2.6 | 0.517 |
Yes | 16 | 12 | 16 | 100.0 | 0 | 0.0 | ||
ProBNP (pg/mL) | Mean (±SD) | 773.20 | 2708.0 | 772.21 | 2734.5 | 815.00 | 1411.6 | 0.979 * |
Left Ventricular Ejection Fraction (LVEF, %) | Mean (±SD) | 51.7 | 21.1 | 52.5 | 20.3 | 20.2 | 34.9 | 0.008 * |
Pulmonary Artery Systolic Pressure (PASP, mmHg) | Mean (±SD) | 27.42 | 16.17 | 28.07 | 15.78 | 0.0 | 0.0 | 0.003 * |
Valvular Heart Disease | None | 90 | 67.7 | 87 | 96.7 | 3 | 3.3 | 0.924 |
Estenosis aortica | 3 | 2.3 | 3 | 100.0 | 0 | 0.0 | ||
Aortic Regurgitation | 4 | 3.0 | 4 | 100.0 | 0 | 0.0 | ||
Mitral Stenosis | 1 | 0.8 | 1 | 100.0 | 0 | 0.0 | ||
Mitral Regurgitation | 17 | 12.8 | 17 | 100.0 | 0 | 0.0 | ||
Other | 16 | 12.0 | 16 | 100.0 | 0 | 0.0 | ||
Wall Motion Abnormality | None | 46 | 34.6 | 44 | 95.7 | 2 | 4.3 | 0.410 |
Akinesia | 38 | 28.6 | 38 | 100.0 | 0 | 0.0 | ||
Hypokinesia | 48 | 36.1 | 47 | 97.9 | 1 | 2.1 |
Outcome | p-Value | |||||||
---|---|---|---|---|---|---|---|---|
Total | Alive | Deceased | ||||||
n | % | n | % | n | % | |||
In-Hospital Management | ||||||||
Hospitalization Days | Mean (±SD) | 5 | 23 | 6 | 14 | −68 | 120 | N/A |
Required ICU Admission | No | 42 | 31.6 | 40 | 95.2% | 2 | 4.8% | 0.407 |
Yes | 83 | 62.4 | 82 | 98.8% | 1 | 1.2% | ||
NYHA Functional Class | I | 49 | 36.8 | 48 | 98.0% | 1 | 2.0% | 0.932 |
II | 47 | 35.3 | 46 | 97.9% | 1 | 2.1% | ||
III | 28 | 21.1 | 27 | 96.4% | 1 | 3.6% | ||
IV | 9 | 6.8 | 9 | 100.0% | 0 | 0.0% | ||
Statins | No | 3 | 2.3 | 0 | 0.0% | 3 | 100.0% | <0.001 |
Yes | 130 | 97.7 | 130 | 100.0% | 0 | 0.0% | ||
Beta Blockers | No | 58 | 43.6 | 55 | 94.8% | 3 | 5.2% | 0.046 |
Yes | 75 | 56.4 | 75 | 100.0% | 0 | 0.0% | ||
Aspirin (Acetylsalicylic Acid) | No | 3 | 2.3 | 0 | 0.0% | 3 | 100.0% | <0.001 |
Yes | 130 | 97.7 | 130 | 100.0% | 0 | 0.0% | ||
Clopidogrel or Ticagrelor | No | 25 | 18.8 | 22 | 88.0% | 3 | 12.0% | <0.001 |
Yes | 108 | 81.2 | 108 | 100.0% | 0 | 0.0% | ||
Anticoagulants | No | 19 | 14.3 | 18 | 94.7% | 1 | 5.3% | 0.340 |
Yes | 114 | 85.7 | 112 | 98.2% | 2 | 1.8% | ||
Type of Anticoagulant | None | 19 | 14.3 | 18 | 94.7% | 1 | 5.3% | <0.001 |
Enoxaparin | 91 | 68.4 | 91 | 100.0% | 0 | 0.0% | ||
Rivaroxaban | 6 | 4.5 | 6 | 100.0% | 0 | 0.0% | ||
Apixaban | 10 | 7.5 | 10 | 100.0% | 0 | 0.0% | ||
Other | 7 | 5.3 | 5 | 71.4% | 2 | 28.6% | ||
Discharge Management | ||||||||
NYHA Functional Class | I | 70 | 52.6 | 67 | 95.7% | 3 | 4.3% | 0.430 |
II | 57 | 42.9 | 57 | 100.0% | 0 | 0.0% | ||
III | 4 | 3.0 | 4 | 100.0% | 0 | 0.0% | ||
IV | 2 | 1.5 | 2 | 100.0% | 0 | 0.0% | ||
Statins | No | 3 | 2.3 | 0 | 0.0% | 3 | 100.0% | <0.001 |
Yes | 130 | 97.7 | 130 | 100.0% | 0 | 0.0% | ||
Beta Blockers | No | 49 | 36.8 | 46 | 93.9% | 3 | 6.1% | 0.022 |
Yes | 84 | 63.2 | 84 | 100.0% | 0 | 0.0% | ||
Aspirin (Acetylsalicylic Acid) | No | 3 | 2.3 | 0 | 0.0% | 3 | 100.0% | <0.001 |
Yes | 130 | 97.7 | 130 | 100.0% | 0 | 0.0% | ||
Clopidogrel or Ticagrelor | No | 31 | 23.3 | 28 | 90.3% | 3 | 9.7% | <0.001 |
Yes | 102 | 76.7 | 102 | 100.0% | 0 | 0.0% | ||
ACE Inhibitor | No | 90 | 67.7 | 87 | 96.7% | 3 | 3.3% | 0.226 |
Yes | 43 | 32.3 | 43 | 100.0% | 0 | 0.0% | ||
Anticoagulants | No | 85 | 63.9 | 82 | 96.5% | 3 | 3.5% | 0.188 |
Yes | 48 | 36.1 | 48 | 100.0% | 0 | 0.0% | ||
Type of Anticoagulant | None | 87 | 65.4 | 84 | 96.6% | 3 | 3.4% | 0.898 |
Enoxaparin | 7 | 5.3 | 7 | 100.0% | 0 | 0.0% | ||
Warfarin | 2 | 1.5 | 2 | 100.0% | 0 | 0.0% | ||
Rivaroxaban | 20 | 15.0 | 20 | 100.0% | 0 | 0.0% | ||
Dabigatran | 1 | 0.8 | 1 | 100.0% | 0 | 0.0% | ||
Apixaban | 16 | 12.0 | 16 | 100.0% | 0 | 0.0% |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Ullauri-Solórzano, V.E.; Fierro Renoy, C.H.; Gaibor Barba, J.C.; Moreira-Vera, D.; Jaramillo Prado, H.O.; Finke Barriga, A.G.; Arias Adriano, V.; Castro Vega, F.X.; Chiliquinga, A.C.; Fonte Melendres, K.; et al. Retrospective Analysis of the Epidemiological and Clinical Characteristics of Acute Coronary Syndrome in a Tertiary Hospital Located at High Altitude. J. Clin. Med. 2025, 14, 6232. https://doi.org/10.3390/jcm14176232
Ullauri-Solórzano VE, Fierro Renoy CH, Gaibor Barba JC, Moreira-Vera D, Jaramillo Prado HO, Finke Barriga AG, Arias Adriano V, Castro Vega FX, Chiliquinga AC, Fonte Melendres K, et al. Retrospective Analysis of the Epidemiological and Clinical Characteristics of Acute Coronary Syndrome in a Tertiary Hospital Located at High Altitude. Journal of Clinical Medicine. 2025; 14(17):6232. https://doi.org/10.3390/jcm14176232
Chicago/Turabian StyleUllauri-Solórzano, Vladimir E., Christian Humberto Fierro Renoy, Juan Carlos Gaibor Barba, Diana Moreira-Vera, Henrry Oswaldo Jaramillo Prado, Ana Gabriela Finke Barriga, Víctor Arias Adriano, Francisco Xavier Castro Vega, Ana Cristina Chiliquinga, Kateherine Fonte Melendres, and et al. 2025. "Retrospective Analysis of the Epidemiological and Clinical Characteristics of Acute Coronary Syndrome in a Tertiary Hospital Located at High Altitude" Journal of Clinical Medicine 14, no. 17: 6232. https://doi.org/10.3390/jcm14176232
APA StyleUllauri-Solórzano, V. E., Fierro Renoy, C. H., Gaibor Barba, J. C., Moreira-Vera, D., Jaramillo Prado, H. O., Finke Barriga, A. G., Arias Adriano, V., Castro Vega, F. X., Chiliquinga, A. C., Fonte Melendres, K., Varela Pólit, L. F., Chediak Pérez, E., Arteaga Yépez, P. E., Paucar Rojas, L. A., Izquierdo-Condoy, J. S., Vasconez-Gonzalez, J., & Ortiz-Prado, E. (2025). Retrospective Analysis of the Epidemiological and Clinical Characteristics of Acute Coronary Syndrome in a Tertiary Hospital Located at High Altitude. Journal of Clinical Medicine, 14(17), 6232. https://doi.org/10.3390/jcm14176232