Clinico-Angiographic Profile of Paramilitary Forces Personnel Presenting With Acute Coronary Syndrome at a Tertiary Care Institute in Jammu and Kashmir, India

Background: Acute coronary syndrome (ACS) is a leading cause of morbidity and mortality in middle-aged adults.However, there is a lack of data on its clinical profile, cardiovascular risk factors, angiographic characteristics, management, and outcomes in armed forces personnel.Thus, this study was conducted to evaluate the clinical characteristics, risk factors, angiographic profile, treatment strategies, complications, and outcomes of ACS among paramilitary forces personnel.Methods: This study included 173 paramilitary forces personnel diagnosed with ACS.Demographic and service-related characteristics, cardiovascular risk factors, clinical presentation, Killip class, laboratory and echocardiographic parameters, time to revascularization, coronary angiographic findings, treatment strategies, procedural complications, and clinical outcomes were evaluated.Results: The mean age of participants was 46.5±7.52 years, and 98.8% (n=171) were male.The most frequent cardiovascular risk factors were smoking (n=99, 57.2%) and hypertension (n=94, 54.3%), followed by dyslipidemia (n=58, 33.5%) and diabetes mellitus (n=49, 28.3%).Anterior wall myocardial infarction was the most common presentation (n=74, 42.8%), followed by inferior wall myocardial infarction (n=64, 36.99%) and non-ST-elevation myocardial infarction (n=21, 12.1%).The mean ejection fraction was 45.6±7.49%, and regional wall motion abnormalities were seen in 76.9% (n=133) of patients.Pharmaco-invasive therapy was the preferred treatment strategy in 68.8% (n=119), with thrombolysis being done in 72.3% (n=125).Coronary angiography was performed in 88.4% (n=153) of cases.The most common angiographic finding was singlevessel disease (n=82, 53.6%), and the left anterior descending artery was the most frequently involved vessel (n=92, 61.7%).The majority (n=99, 78.0%) of patients who underwent percutaneous coronary intervention (PCI) had a single stent.The most common electrical complications were complete heart block (n=8, 4.6%) and ventricular tachycardia (n=7, 4.0%).Conclusions: ACS in paramilitary forces personnel predominantly affected middle-aged men and was associated with a high prevalence of modifiable cardiovascular risk factors, especially smoking and hypertension.Main management strategies were pharmaco-invasive therapy and coronary intervention.Early identification of cardiovascular risk factors and prompt reperfusion may improve prognosis in this population.