GUIDELINES FOR ADMISSION TO CORONARY CARE UNIT AND

INTERMEDIATE CORONARY CARE UNITS. (8 BEDS EACH)

Source of admission E.T.U

1.
2.
3.
4.
5.
6.

Acute STEMI
Acute NSTEMI
Unstable Angina
Complicated cardiac arrythmias (CAD, Rheumatic
Heart Disease, Kanero Poisoning)
Severe Cardiac failure (CAD, CRHD, Cardiomyopathy)
Others Myocarditis, Pericardial effusion, Chronic
complete heart block (Symptomatic)

Number of admissions to CCU & ICCU

(November, December 2005 & January 2006)

Total No. of Admissions 178

Males
Females
No of Deaths

Nov.
197
125
53
9

Dec.
214
135
62
14

Jan.
159
55
12

Age Distribution
No. of Males & Females
Age

Nov.

Dec.

Jan.

30-40

7/ 5

11/4

12/-

41-50

18/4

34/4

20/3

51-60

46/14

39/13

41/15

61-70

33/18

28/15

48/16

71 <

23/11

23/27

41/18

Diagnosis on admission

STEMI
NSTEMI / unstable angina
CRHD

Nov.
70
74
11

Dec.
67
113
6

Jan.
65
126
6

13

14

17

Others
Myocarditis
Pericardial effusion
Cardiomyopathy
Kaneru Poisoning

Major risk factors detected on admission

Diabetes mellitus
Hypertension
Smoking
Dyslipidaemia
Family history

Nov.
27
36
20
NA
10

Dec.
27
35
31
NA
12

Jan.
40
51
31
NA
14

Main objectives for prevention in patients with

established CVD and in high risk people
-

No smoking
Make healthy food choices
Be physically active
Body mass index <25 kg / m 2
Bloody pressure < 140/90 mmHg in most, < 130/80 mmHg in
particular groups*
Total cholesterol < 5 mmol/l (190 mg /dl) in most. <2.5 mmol/l
(100 mg / dl) in particular groups*
LDL-cholesterol < 3mmol/l (115 mg / dl) in most. <2.5 mmol/l
(100 mg/dl) in particular groups*
Good glycaemic control in all persons with diabetes
Consider other prophylactic drug therapy in particular patient
groups*

What priorities to set, given limited resources ?

The priorities for CVD prevention in clinical practice are:
1.
Patients with established coronary heart disease, peripheral artery
disease and cerebrovascular atheroscierotic disease.
2.
Asymptomatic individuals who are at high risk of developing
atherosclerotic cardiovascular disease because of
a.
multiple risk factors resulting in a 10 year risk of > 5%
now (or if extrapolated to age 60) for developing a fatal
CVD event.
b.
markedly raised levels of single risk factors
cholesterol > 8 mmol/l (320 mg/dl), LDL cholesterol > 6
mmol/l (240 mg/dl), blood pressure > 180/110 mmHg
c.
Diabetes type 2 diabetes type 1 with microalbuminuria
3.

Close relatives of
a.
patients with early onset atheroscierotic cardiovascular
disease
b.
asymptomatic individuals at particularly high risk

4.

Other individuals encountered in routine clinical practice

Why screen close relatives?

Close relatives of patients with premature coronary heart
disease (men <55 years and women < years) and
persons who belong to families with familial
hypercholesterolemia or other inherited dyslipidemias
should be examined for cardiovascular risk factors,
because all of these persons are al increased risk of
developing cardiovascular disease.