Pattern and Outcome of Ischemic Heart Disease in Patients Admitted To Jimma University Specialized Hospital, Southwest Ethiopia

Abstract

Background: Ischemic heart disease is the burgeoning problem in the world in US in 2010 affected 17.6million persons and worldwide the number one cause of death. Cardiovascular disease is one of the top ten causes of death in Ethiopia, and ischemic heart disease is increasing in incidence. The commonest traditional risk factors are family history of CVDs, cigarette smoking, diabetes mellitus, hypertension and dyslipidemia with obesity and also other nontraditional risk factors. The commonest presentation of the patients being acute coronary syndromes one of (STEMI, NSTEMI or unstable angina) and some patients with prior MI can present as ischemic heart failure. The severity of the ischemia is the best predictor of in hospital mortality and prognosis of the patient in the long run. Objective: The objective of this study is to assess the commonest risk factors, the leading presenting feature and to determine the outcome of IHD patients admitted to JUSH medical wards during the study period. Methods: A prospective hospital based cohort study was conducted for consecutive patients admitted to medical wards with diagnosis of IHD between October, 2014 to August, 2015. Total of 80 samples were collected over the study period. The data was organized, coded, entered, cleaned, and analyzed using SPSS version 20.0. Descriptive statistics and binary logistic regression analysis were done. Results: Data collected from 80 IHD patients were included in the analysis. Forty nine (61.2%) of them were males. The mean age of the study subjects was 59.47+/- 11.75. Forty (50%) of them were in the age group of above 60 years and eleven (13.75%) are below 45years. Sixty (75%) of them were married. Majority of (26)32.5% of the respondents were farmers. Of the total 80 subjects in the study admitted with the diagnosis of ischemic heart disease 49(61.25%), 18(22.5%) and 13(16.25%) are diagnosed with chronic ischemic heart disease, Non ST elevation myocardial infarction/unstable angina and ST elevated myocardial infarction respectively. Of the admitted patients 38.75% have systolic hypertension and 35% have diastolic hypertension. Patients present with chest pain in 47.5% of cases and most of them (85%) present with class IV heart failure. Of the admitted patients thirteen (16.3%) died in the hospital out of which majority 41.67% are due to chronic ischemic heart disease. Conclusion and recommendation: based upon this study the leading risk factor for ischemic heart disease is diabetes mellitus, so adequate treatment of diabetic patients can decrease number of patients. In patients with ischemic heart disease intensive control of risk factors will improve outcome of patients.