Impact of creating a hemodynamics room, a coronary care unit, and a primary angioplasty program on the prognosis of acute coronary syndrome in a district hospital

Author(s):  
M.N. Solís-Marquínez ◽  
J.J. Rondán-Murillo ◽  
M. Pérez-Otero ◽  
J.M. Vegas-Valle ◽  
Í. Lozano Martínez-Luengas ◽  
...  
2021 ◽  
Vol 4 (3/4) ◽  
pp. 131-134
Author(s):  
Gilson Feitosa ◽  
Leandro Cavalcanti ◽  
Amanda Fraga ◽  
Milana Prado ◽  
Gilson Feitosa Filho ◽  
...  

The coronary care unit by Santa Izabel Hospital (Salvador, Bahia, Brazil) made a comparison of admitted patients with coronary disease cases admitted between two equivalent periods ranging from April through July in 2019 and 2020. There was a striking reduction in 2020 of cases of ST-elevation myocardial infarction (39%); non-ST elevation myocardial infarction (19%); and unstable angina pectoris (21%). This occurred in parallel with what happened in many parts of the world and hampered offering the best treatment strategy to these patients with an acute coronary syndrome such as invasive stratification and myocardial revascularization.  


2020 ◽  
Vol 5 (1) ◽  
pp. 28-34
Author(s):  
Amanj Abubakr Jalal Khaznadar ◽  
Rebin Wahid Salh

Background: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI ) are common types of acute coronary syndrome which are associated with the risk factors of age, obesity, hypertension, and diabetes. Objective: The present study aimed to examine the effects of age on the risk factors and clinical symptoms of acute coronary syndrome. Methods: A cross-section prospective study was conducted on 125 patients with acute coronary syndrome chosen by non-probability convenience sampling method in the coronary care unit in Sulaimani, the Kurdistan region of Iraq. Acute coronary syndrome types were diagnosed through clinical presentations, electrocardiography (ECG), and troponin test. Data was collected using a researcherbased checklist through face-to-face interviews. Results: The results indicated that males were the dominant group. The age group 45-65 had the highest prevalence rate of acute coronary syndrome. The most frequent risk factors for acute coronary syndrome were hypertension (54.4%), dyslipidemia (52%), smoking (42.4%), and diabetes mellitus (38.4%). Typical chest pain was found to be the most frequent clinical presentation (88%). There was a significant difference between the age groups in terms of the effect of age on typical and atypical symptoms; however, neither age nor typical/atypical symptoms had a significant effect on type of acute coronary syndrome. Similarly, family history, hypertension, diabetes mellitus, obesity, smoking, physical inactivity, and dyslipidemia had no effect on type of acute coronary syndrome. Conclusion: Age is a predictive factor for acute coronary syndrome, but family history, hypertension, diabetes mellitus, obesity, smoking, physical inactivity, and dyslipidemia cannot predict acute coronary syndrome.


2013 ◽  
Vol 12 (4) ◽  
pp. 26-31
Author(s):  
A. V. Panina ◽  
N. F. Puchinyan ◽  
Ya. P. Dovgalevskyi ◽  
N. V. Furman ◽  
P. V. Dolotovskaya ◽  
...  

Aim. To study the association of plasma D-dimer levels and the risk of thrombotic events in patients hospitalised with acute coronary syndrome (ACS).Material and methods. The study included 70 patients, aged 34-88 years, who were admitted to the Acute Coronary Care Unit with the ACS diagnosis.Results. During the follow-up period, thrombotic events were registered in 12 patients (17%). Three patients with myocardial infarction (MI) suffered recurrent MI. Nine patients were rehospitalised with the unstable angina (UA) diagnosis. All participants were divided into quartiles by the levels of D-dimer (25% percentile 136 ng/ml; median 1250 ng/ml; and 75% percentile 2930 ng/ml). High plasma levels of D-dimer (third quartile) were associated with a 1,5-fold increase in the risk of recurrent thrombotic events among ACS patients.Conclusion. In ACS patients, plasma D-dimer levels could be regarded as one of the additional risk factors of thrombotic events. 


2020 ◽  
pp. 204887262093603
Author(s):  
Marc Ferrer ◽  
Cosme García-García ◽  
Nabil El Ouaddi ◽  
Ferran Rueda ◽  
Jordi Serra ◽  
...  

Background: Coronary care units were established in the 1960s to reduce acute-phase mortality in acute coronary syndrome. In the 21st century, the original coronary care unit concept has evolved into an intensive cardiovascular care unit. The aim of this study was to analyse trend changes in characteristics and mortality of patients admitted to a coronary care unit over the past three decades. Method: Between February 1989 and December 2017, a total of 18,334 patients was consecutively admitted to the coronary care unit of a university hospital in Barcelona. Data were analysed in five time frames: 1989–1994, 1995–1999, 2000–2004, 2005–2009 and 2010–2017. We analysed demographic profile, diagnoses at admission and trend changes in mortality across periods. Results: During the periods, the patients’ ages and comorbidities increased. Diagnoses at admission have evolved. Acute coronary syndrome cases declined from the first to the last period (72.6% vs. 62.8%) while heart failure (6.0% vs. 8.6%) and malignant arrhythmias (0.8% vs. 4.0%) increased significantly. Overall, coronary care unit mortality decreased 34% from the first to the last period (6.8% vs. 4.5%, P<0.001). Furthermore, the cause of death has changed, those due to acute coronary syndrome declining (66.7% vs. 45.5%), and death from malignant arrhythmias increasing (1.9% vs. 16.2%) from the first to the last period. Conclusions: Although acute coronary syndrome remained the main diagnosis, heart failure and arrhythmias have increased. Despite the aging and comorbidities, overall mortality in the coronary care unit decreased by 34% in the past three decades. Deaths due to acute coronary syndrome have declined, whereas those due to malignant arrhythmias have increased.


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