1.Prevalence of coronary artery disease among adult patients with congenital heart disease who underwent coronary angiogram at the University of the Philippines-Philippine General Hospital from September 1998 to November 2011.
Matulac Melgar O ; Punzalan Felix Eduardo R ; Tiongco Richard Henry P ; Reganit Paul Ferdinand M ; Gumatay Wilbert Allan G ; Balabagno Maria Margarita O
Acta Medica Philippina 2014;48(2):29-34
OBJECTIVES: To determine prevalence of coronary artery disease (CAD) among adult patients with congenital heart disease (CHD), who underwent Coronary Angiography (CA) at the UP-PGH. Secondary: to determine severity of CAD lesions among these patients.
METHODS: This is a descriptive study of adult patients with Congenital Heart Disease who underwent selective coronary angiography from September 1998 to December 2010 at the Philippine General Hospital.
RESULTS: 52 adult patients with CHD underwent CA, Ten (19%) had angiographic evidence of coronary atherosclerosis visually. Significant CAD was found in 11.5% (n=6), all patients being ≥ 40 years old (mean age 54 ± 7.9 years; range 47 -61); 4 (66%) are female; Five (83%) have documented traditional CVD risk factors, mostly hypertensive (33%). None with significant CAD had cyanosis, 4 patients (66%) have typical chest pain. Majority of CHD's were simple (61%), mostly atrial septal defects (36%). Four (n=4)(70%) patients with Simple CHD, 2 (30%) patients with Intermediate CHD and none of those with Complex CHD had significant CAD.
CONCLUSION: Prevalence of CAD among ACHD patients using CA in this study is 11.5%. This study supports the notion of routine CA among patients with ACHD ≥ 35 years old with traditional CV risk factors. Need for primary prevention of CAD and modification of traditional CV risk factors among these patients is emphasized, as important with the general population.
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Heart Diseases-congenital ; Coronary Artery Disease-Prevalence ; Coronary Angiography
2.Quality of care of adult patients with ST-Elevation Myocardial Infarction (STEMI) at the emergency room of a tertiary hospital in the Philippines.
Valerie R. RAMIRO ; Marc Denver A. TIONGSON ; Jezreel L. TAQUISO ; Lauro L. ABRAHAN ; Maria Margarita O. BALABAGNO ; John Daniel A. RAMOS ; Felix Eduardo R. PUNZALAN
Acta Medica Philippina 2022;56(6):112-123
Introduction. Coronary artery disease (CAD) remains a significant public health problem worldwide and in the Philippines. Adherence to guideline-directed therapy improves the quality of care (QOC).
Objective. We aimed to evaluate the QOC initially received by ST-Elevation Myocardial Infarction (STEMI) patients at our Emergency Room (ER), based on compliance to 2014 PHA CAD guidelines recommendations.
Methods. We reviewed the charts of adult patients with STEMI admitted at the ER who were not previously managed in a different hospital. The primary outcome was QOC assessed through quality indicators (QI) based on class I and IIa recommendations in the PHA CAD guidelines.
Results. Of the 29 patients included, all had ECG done upon admission, but only four were done within 10 minutes (QI: 13.79%). All eligible patients received antiplatelets (QI: 100%). Six eligible patients (QI: 100%) received nitrates, and four eligible patients (QI: 100%) received morphine. Of 16 eligible patients, only six were reperfused within the recommended 12 hours of ischemia (QI: 37.5%), two by thrombolysis and four by the primary percutaneous coronary intervention (PCI).
Conclusion. The timely performance of initial ECG and reperfusion need improvement. Suitable performance measures for the provision of nitrates and morphine to eligible patients were met. Investigating intrinsic and extrinsic factors that lead to the time delays observed are also recommended.
ST Elevation Myocardial Infarction ; Emergency Service, Hospital
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