• Muhammad Nauman Qureshi, Eman Nayaz Ahmed, Khaled Abdulrahman Ahmed, and Eyad Bashtawi.
• From the Department of Emergency Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
• Ann Saudi Med. 2024 Jan 1; 44 (1): 1101-10.

BackgroundAcute coronary syndrome (ACS) comprises a spectrum of diseases ranging from unstable angina (UA), non-ST elevation myocardial infarction (non-STEMI) and ST elevation myocardial infarction (STEMI). Treatment of ACS without STEMI (NSTEMI-ACS) can vary, depending on the severity of presentation and multiple other factors.ObjectiveAnalyze the NSTEMI-ACS patients in our institution.DesignRetrospective observational.SettingA tertiary care institution with accredited chest pain center.Patients And MethodsThe travel time from ED booking to the final disposition for patients presenting with chest pain was retrieved over a period of 6 months. The duration of each phase of management was measured with a view to identify the factors that influence their management and time from the ED to their final destination. The data was analyzed using descriptive statistics.Main Outcome MeasuresTravel time from ED to final destination.Sample Size300 patients.ResultsThe majority of patients were males (64%) between 61 and 80 years of age (45%). The median disposition time (from ED booking to admission order by the cardiology team) was 5 hours and 19 minutes. Cardiology admissions took 10 hours and 20 minutes from ED booking to the inpatient bed. UA was diagnosed in 153 (51%) patients and non-STEMI in 52 (17%). Coronary catheterization was required in 79 (26%) patients, 24 (8%) had coronary artery bypass grafting (CABG) and 8 (3%) had both catheterization and CABG.ConclusionThe time from ED booking to final destination for NSTEMI-ACS patients is delayed due to multiple factors, which caused significant delays in overall management. Additional interventional steps can help improve the travel times, diagnosis, management and disposition of these patients.LimitationsSingle center study done in a tertiary care center so the results from this study may not be extrapolated to other centers.

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