Masood Jawaid, Abdus Samad, Mohammad Ishaq, Shaukat Ali Jawaid.
Use of Aspirin in acute coronary syndrome in a tertiary care hospital in Karachi.
Pak J Med Sci Jan ;18(2):87-94.

Background: Large body of scientific evidence exists that use of Aspirin in acute myocardial infarction and other subsets of coronary heart disease significantly reduces morbidity and mortality. Aspirin has proved a life saving medication if taken in the early hours of myocardial infarction. This study was conducted to find out the aware- ness and actual use of Aspirin in patients with acute chest pain due to AMI and other acute coronary syndromes. Design: Randomized prospective study. Setting: National Institute of Cardiovascular Diseases (NICVD) Karachi, Pakistan. Patients and Methods: Two hundred consecutive patients admitted to NICVD with the history of recent onset acute chest pain suggestive of myocardial ischemia/infarction. A questionnaire regarding the time of onset of chest pain, time interval of chest pain and use of Aspirin (chewed or swallowed), cause of chest pain, first consultation, use of any other remedy, risk factors, financial status, use of different types of fat, profession, family members and counseling about use of Aspirin were asked by the first author. Results: The study included 200 patients, 150 males (75%) and 50 females (25%). 25 (12.5%) of patients, 21 (10.5%) males and 4 (2%) females were between the age of 31-40 years, 59 (29.5%), males 41 (20.5%), females 18 (9%) were in 41-50 years, while 65 (32.5%), males 50 (25%) and females 15 (7.5%) were between the age of 51-60 years. 75 (37.5%) were labourers. 191 (95.5%) belonged to lower socio-economic group with income of < Rs.10,000/- per month. Majority 129 (64.5%) were illiterate or had primary education. 141 (70.5%) of patients took Aspirin within 6 hours. 21 (10.5%) used Aspirin at home. Although 47 (23.5%) patients first consulted a GP only 11 (23.4%) were given Aspirin. 15 (7.5%) got Aspirin at local hospital and 153 (76.5%) in NICVD. 102 (51%) patients came to NICVD directly. 77 (38.5%) got thrombolytic therapy. Pepsi (or cold drink), analgesics, syrup mucain, other digestives and Bam were the other drugs and substances first used after chest pain. Stress, Hypertension, smoking, hyperlipidemia, family history, obesity and diabetes mellitus were the important risk factors. 39 (19.5%) received counseling regarding benefits of Aspirin therapy. Conclusion: Despite compelling evidence regarding the known benefits, awareness about use of Aspirin among general physicians and community hospitals is highly unsatisfactory. Health Care Professionals need to be educated besides creating awareness among the public about the benefits of Aspirin therapy, using all available resources including the mass media.

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