scholarly journals TCT-622 The impact of proteinuria for patients with contrast induced nephropathy After Acute Coronary Syndromes

2017 ◽  
Vol 70 (18) ◽  
pp. B276
Author(s):  
Naohiko Nemoto ◽  
Hitoshi Anzai ◽  
Nobuyuki Kobayashi ◽  
Masato Nakamura
Keyword(s):  
Acute Coronary Syndromes ◽  
Contrast Induced Nephropathy ◽  
Coronary Syndromes ◽  
The Impact

Abstract 13433: Predictors of Contrast Induced Nephropathy in Patients With Acute Coronary Syndromes and Normal Baseline Glomerular Filtration Rate

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Negreanu ◽  
Michael Gagnon ◽  
anh nguyen ◽  
Samer Mansour ◽  
Michel T Nguyen ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Acute Coronary Syndromes ◽  
Filtration Rate ◽  
Fold Increase ◽  
Contrast Induced Nephropathy ◽  
Baseline Serum ◽  
Coronary Syndromes ◽  
The Mean

Background: The incidence and predictors of contrast-induced nephropathy (CIN) in patients with normal glomerular filtration rate (GFR) are not well ascertained. We aim to determine the incidence and predictors for CIN after coronary catheterization (CATH) for acute coronary syndromes (ACS). Methods: We combined the datasets of two studies. The AMI-QUEBEC was an observational cohort of patients with ST-segment elevation myocardial infarctions in 2003. The AMI-OPTIMA was a study of patients hospitalized with ACS in 2009 and 2012. For this analysis, we retained only patients with GFR > 60 ml/min who underwent CATH. We defined “hyperfiltrators” as patients with GFR above the 95th percentile age and sex-adjusted value. CIN was defined as an increase in serum creatinine >0.5 mg/dL (44.2 μmols/L) or > 50% from baseline serum creatinine. Results: There were 3,188 patients with GFR > 60 ml/min : 39 hyperfiltrators and 3,149 without hyperfiltration. The mean age was similar between the two groups of patients (62 years); 21% and 27% females in hyperfiltrators and non-hyperfiltrators (p<0.0001). The prevalences of diabetes mellitus and hypertension were 36% and 64%, respectively in hyperfiltrators compared to 20% and 46%, respectively in non-hyperfiltrators. The mean baseline GFR and creatinine were 112 ml/min and 50 μmols/L, respectively in hyperfiltrators; 84.2 ml/min and 80 μmols/L in non-hyperfiltrators. There were 225 CIN following CATH; 7.1% of the whole cohort with 35.9% in the hyperfiltrators and 6.7% in non-hyperfiltrators. Hyperfiltration was independently associated with a 13-fold increase in the risk of CIN (Table 1). Each year of increase in age was associated with a 5% increase in the risk of CIN. Shock was also associated with an 11-fold increase in the risk of CIN. Conclusion: Hyperfiltrators may be at high risk of CIN following CATH in ACS. The risk of CIN associated with hyperfiltration should be evaluated in other populations.

scholarly journals The Impact of Aspirin Resistance on the Long-term Cardiovascular Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndromes

2009 ◽  
Vol 32 (3) ◽  
pp. 142-147 ◽  
Author(s):  
Stefanos G. Foussas ◽  
Michael N. Zairis ◽  
Vasilios G. Tsirimpis ◽  
Stamatis S. Makrygiannis ◽  
Nikolaos G. Patsourakos ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Acute Coronary Syndromes ◽  
Aspirin Resistance ◽  
St Segment Elevation ◽  
St Segment ◽  
Coronary Syndromes ◽  
The Impact

The impact of atrial fibrillation type during acute coronary syndromes

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P5615-P5615
Author(s):  
C. Galvao Braga ◽  
V. Ramos ◽  
J. Martins ◽  
C. Arantes ◽  
C. Vieira ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Acute Coronary Syndromes ◽  
Coronary Syndromes ◽  
The Impact

scholarly journals Admissions and In-hospital Outcomes of Acute Coronary Syndromes during Corona Virus Disease 19 Pandemic in Albania

2021 ◽  
Vol 9 (B) ◽  
pp. 593-599
Author(s):  
Leonard Simoni ◽  
Ilir Alimehmeti ◽  
Astrit Ceka ◽  
Ermir Tafaj ◽  
Mirald Gina ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Virus Disease ◽  
Control Period ◽  
Fold Increase ◽  
University Hospital ◽  
Distance Measures ◽  
Invasive Procedures ◽  
Coronary Syndromes ◽  
St Elevation ◽  
The Impact

   BACKGROUND: Cardiologists and surveys from all over the world have reported an important drop in admissions of patients with acute coronary syndromes (ACS) and related coronary procedures during the outbreak of coronavirus disease 19 (COVID 19) pandemic. AIM: We investigated the impact of the COVID 19 pandemic on hospitalizations for ACS and related invasive procedures in a country with low COVID 19 incidence. METHODS: We conducted a single-center, observational retrospective study including all consecutive patients admitted for ACS in the Cardiology Department of University Hospital Center Mother Theresa from March 9, 2020 (1st day of application of social distance measures) to April 30th (period of total lockdown). Patients admitted in the same time period in 2019 served as controls. All data were collected from the medical files. Admissions were classified as ST-elevation myocardial infarction (STEMI) or non-ST-elevation ACS (NSTEACS). Total and weekly admissions and invasive procedures were assessed. Mean incidence difference (MID) in weekly ACS admissions and procedures was also calculated. RESULTS: Overall, 781 patients were included in this analysis: 321 patients (37%) were admitted during study period and 550 patients (63%) were admitted during the control period (overall reduction of 41.6%; weekly MID of 28.6 (95% confidence interval [CI] 13.3 to 44.0; p = 0.001). The occurrence of all ACS types was reduced: STEMI, by 28.1%; weekly MID 7.3 [0.6-15.2]; p = 0.048]; NSTEACS by 50.5%, weekly MID 19.1 [13.9-24.4]; p < 0.001]. Invasive procedures were also reduced: coronary angiography by 42.5%, weekly MID 26.6 [13.4-39.2]; p = 0.001]; percutaneous coronary intervention (PCI) by 42.3%, weekly MID 16.1 [5.9-26.3], p = 0.004]. Compared to 2019, during the COVID-19 period, there was a 2.4 fold increase in the inhospital death (3% vs 7.2%) with a significant weekly MID 1.4 [0.2-2.7) P=0.032]. A 2.6-fold increase in the occurrence of cardiogenic shock was also observed (13.1% vs. 5.1%, p < 0.0001). CONCLUSIONS: The admissions for ACS and invasive revascularization procedures were significantly reduced, whereas the death rate was increased during COVID 19 pandemic outbreak in Albania compared with the same period in 2019.

scholarly journals Impact of Postdilation on Intervention Success and Long-Term Major Adverse Cardiovascular Events (MACE) among Patients with Acute Coronary Syndromes

2020 ◽  
Vol 4 (3) ◽  
pp. 185-193
Author(s):  
Turan Erdoğan ◽  
Hakan Duman ◽  
Mustafa Çetin ◽  
Savaş Özer ◽  
Göksel Çinier ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Drug Eluting Stent ◽  
Timi Flow Grade ◽  
Coronary Interventions ◽  
Coronary Syndromes ◽  
The Impact ◽  
Myocardial Blush Grade

Postdilation is frequently used during coronary interventions to prevent stent malapposition. Currently there are contradictory findings regarding the benefits of postdilation for both intraprocedural and long-term outcomes. We evaluated the impact of postdilation among patients who presented with acute coronary syndromes (ACS) and underwent percutaneous coronary interventions (PCI). A total of 258 consecutive patients who presented with ACS and underwent PCI were included in the study. The patients were followed up for 25±1.7 months for the occurrence of major adverse cardiovascular events (MACE). During follow-up, 65 patients (25.2%) had MACE. Among patients without MACE, intracoronary nitrate infusion was less frequently used (P=0.005), myocardial blush grade was higher (P<0.001), and a drug-eluting stent was more frequently used (P=0.005). No significant differences were noted between groups regarding the predilation, recurrent dilation, postdilation, and other angiographic characteristics. In multivariate analysis, female sex (P=0.047), myocardial blush grade (P=0.038), previous coronary artery disease (P=0.030), and peak troponin level (P=0.002) were found to be predictors of MACE. In patients who were treated with PCI for ACS, performing postdilation did not predict final Thrombolysis in Myocardial Infarction (TIMI) flow grade, corrected TIMI frame count, myocardial blush grade, or MACE.

scholarly journals COVID-19 and Acute Coronary Syndromes: Current Data and Future Implications

2021 ◽  
Vol 7 ◽  
Author(s):  
Matteo Cameli ◽  
Maria Concetta Pastore ◽  
Giulia Elena Mandoli ◽  
Flavio D'Ascenzi ◽  
Marta Focardi ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Healthcare Providers ◽  
Current Data ◽  
Hospital Environment ◽  
Healthcare Personnel ◽  
Clinical Approach ◽  
Mortality And Morbidity ◽  
The World ◽  
Coronary Syndromes ◽  
The Impact

Coronavirus disease-2019 (COVID-19) pandemic is a global healthcare burden, characterized by high mortality and morbidity rates all over the world. During the outbreak period, the topic of acute coronary syndromes (ACS) has raised several clinical issues, due to the risks of COVID-19 induced myocardial injury and to the uncertainties about the management of these cardiologic emergency conditions, which should be organized optimizing the diagnostic and therapeutic resources and ensuring the maximum protection to healthcare personnel and hospital environment. COVID-19 status should be assessed as soon as possible. Moreover, considerably lower rates of hospitalization for ACS have been reported all over the world, due to patients' hesitations to refer to hospital and to missed diagnosis. As a result, short- and long-term complications of myocardial infarction are expected in the near future; therefore, great efforts of healthcare providers will be required to limit the effects of this issue. In the present review we discuss the impact of COVID-19 pandemic on ACS diagnosis and management, with possible incoming consequences, providing an overview of the available evidence and suggesting future changes in social and clinical approach to ACS.

scholarly journals Angioplasty with Stenting in Acute Coronary Syndromes with Very Low Contrast Volume Using 6F Diagnostic Catheters and Bench Testing of Catheters

2019 ◽  
Vol 7 (6) ◽  
pp. 1004-1012
Author(s):  
Mark Christopher Arokiaraj
Keyword(s):  
Acute Coronary Syndromes ◽  
Target Lesion ◽  
Path Model ◽  
Force Transmission ◽  
Contrast Induced Nephropathy ◽  
Low Contrast ◽  
Contrast Volume ◽  
Femoral Route ◽  
Coronary Syndromes ◽  
Bench Testing

AIM: To safely perform angioplasties in acute coronary syndromes with low contrast volume using Cordis 6F diagnostic catheters and to perform mechanical bench tests on the diagnostic and guide catheters in a radial path model. METHODS: In 191 patients (242 lesions/268 stents) with acute coronary syndromes angioplasty were performed with cordis 6F diagnostic catheters. RESULTS: The lesions were present at left anterior descending (121), Left main (5), left circumflex (51), ramus (5) and right coronary artery (60). In 72% of cases, Iodixanol was used. All contrast injections were given by hand. Regular follow-up of the patients was performed at 30 days. The procedures were performed in the femoral route only. Pre-dilatation was performed in 43 cases. Successful revascularization of the target lesion was achieved in all cases. The mean contrast volume used per patient was 28 ml (± 8 ml). Mild reversible contrast-induced nephropathy (CIN) was observed in two patients. Cardiogenic shock was seen in 7 cases, and one death was observed. Pushability and trackability tests showed good force transmission and hysteresis in diagnostic catheters compared to guide catheters. CONCLUSIONS: Angioplasty with stenting could be performed safely in patients using cordis 6F diagnostic catheters using a low volume of contrast in acute coronary syndromes. Low contrast volume usage would result in a lower incidence of contrast-induced nephropathy and cardiac failures.

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