scholarly journals A study of drug utilization trends in acute coronary syndrome in intensive cardiac care unit at a tertiary care hospital, Mysore

2017 ◽  
Vol 6 (2) ◽  
pp. 344
Author(s):  
Saranya Kalyanasundarram Lakshmi ◽  
Hema Narasimhe Gowda ◽  
Kanchanahalli Siddegowda Sadananda
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cardiac Care ◽  
Inferior Wall ◽  
Care Hospital ◽  
Who Criteria ◽  
Coronary Syndrome ◽  
Cardiac Care Unit

Background: Acute Coronary Syndrome (ACS) is an emergency condition where usage of many drugs during its management in ICCU is common. This could be a potential cause for Polypharmacy, Potential Drug-Drug Interactions and increased Cost Burden on patients. The objective of the study was WHO criteria for prescription like, 1) Average number of drugs per prescription, 2) Percentage of drugs prescribed by Generic name, 3) Percentage of drugs with Injections prescribed, 4) Percentage of prescriptions with Antibiotics and 5) Percentage of drugs prescribed from the WHO Essential Drugs List.Methods: After obtaining approval from Institutional Ethics Committee, an observational study was carried out among 125 patients in a tertiary care hospital, Mysore. Patients diagnosed with ACS admitted in Intensive Cardiac Care Unit (ICCU) for initial 48 hrs were included in the study. The prescriptions were analyzed for WHO criteria for prescription. The results were analyzed using Descriptive Statistics and T- test.Results: In our present study the most common diagnoses were found to be ACS- Anterior wall myocardial infarction (36.8%) and ACS-Inferior wall myocardial infarction (32.8%). Hypertension (35.2%) and Type 2 diabetes mellitus (29.6%) were the frequently associated co-morbid conditions. Antiplatelet drugs (100%) and Hypolipidemic drugs (100%) were the most commonly prescribed, followed by Anti coagulants (94.4%). The average number of drugs per prescription was 9.09±2.17. Percentage of drugs prescribed by generic names was 37.29%. The percentage of drugs prescribed from essential drug list was 50.84%.Conclusions: The present study provides valuable insight about the overall pattern of drugs used in Acute Coronary syndrome. Physician should be encouraged to prescribe drugs with generic name.

scholarly journals Thyroid profile as a marker of poor prognostic factor in patients with acute coronary syndrome: a tertiary care hospital based observational study

2018 ◽  
Vol 15 (1) ◽  
pp. 39-41 ◽  
Author(s):  
Navaraj Paudel ◽  
Vijay Madhav Alurkar ◽  
Ramchandra Kafle ◽  
Abhishek Maskey ◽  
Subash Sapkota
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Unstable Angina ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hormonal Changes ◽  
Poor Prognostic Factor ◽  
Coronary Syndrome ◽  
St Segment ◽  
Significant Difference

Background and aims: Serum thyroid hormonal changes can occur in acute or chronic non-thyroidal systemic illness including acute coronary syndrome in otherwise euthyroid individuals. In this study we aimed to assess thyroid hormonal profile in patients presenting with acute coronary syndromes (ACS) and compare between ST segment elevated myocardial infarction and unstable angina/Non ST segment elevated myocardial infarction.Methods: A hospital based, retrospective, observational comparative study was designed. Data of all patients with acute coronary syndrome presenting to hospital were collected from July 2015 through June 2017 in a pre-structured proforma and analyzed.Results: A total of 200 ACS patients between 23 years to 88 years with mean age of 61.33 ± 12.30 years were studied. One hundred and twenty seven (63.5%) were males. Among them 116 (58%) was ST segment elevated myocardial infarction (STEMI) patients while 84 (42%) were unstable angina/ non-ST elevated myocardial infarction (UA/ NSTEMI) patients. Total 47 (23.5%) patients had abnormal TFT of which 28(59.5%) had Euthyroid Sick Syndrome, 12(25.5%) had subclinical hypothyroidism, 5(10.6%) had subclinical hyperthyroidism and 2(4.25%) had low fT4 with normal fT3 and normal TSH. There was significant difference in TFT in patients with STEMI and UA/NSTEMI (P=0.006).There were higher rates of heart failure (p= 0.001 & 0.003 in STEMI & UA/NSTEMI respectively), longer length of hospital stay (3+0.17 days) and high mortality (more than 4 fold) in all types of ACS patients with abnormal TFT than ACS patients with normal TFT.Conclusion: There is higher prevalence of abnormal thyroid hormonal findings in ACS causing significant morbidity and mortality.

scholarly journals Platelet Volume Indices in Patients with Acute Coronary Syndrome

2020 ◽  
pp. 1-5
Author(s):  
Ekta Paramjit ◽  
S. Sudhamani ◽  
Anita Sharan ◽  
Sonali Pitale ◽  
Prakash Roplekar
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
St Elevation Myocardial Infarction ◽  
Cardiac Care ◽  
Platelet Volume ◽  
Distribution Width ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Cardiac Care Unit

Background & Aims: Acute coronary syndrome is one of the leading causes of morbidity and mortality in the world and platelet hyperactivity with local platelet activation plays a crucial role in its genesis. As there is discrepancy regarding the significance of deranged platelet parameters, we aimed to study the role of platelet volume indices in the spectrum of coronary artery syndrome and to correlate them clinically. Study Design: The study was conducted by collecting the data of patients with Myocardial infarction from the Cardiac care unit registry along with their clinical history and investigations. Stable coronary artery cases were collected from the Catheterization Lab and compared with Age and Sex matched controls. All CBCs of the above groups were processed by a 5-part counter and the data generated was transferred to a master chart for statistical analysis. Place and Duration of study: The study was conducted in the Central Laboratory & Department of Pathology at D.Y. Patil Hospital, Navi Mumbai, India in collaboration with the Cardiac Care Unit and Catheterisation Lab of the hospital for a period of two years. Methods: A total of 122 cases were studied and grouped into 5 groups according to presentation and the platelet volume indices of these were compared with 38 matched controls and statistically analysed. Results: Mean Platelet Volume and Platelet Distribution Width of patients with ST elevation Myocardial Infarction (STEMI) and Non ST elevation Myocardial Infarction(NSTEMI) were increased marginally in number when compared to Stable Coronary Artery Disease(SCAD) and Control group, however this was not statistically significant. Platelet Large Cell Ratio (PLCR) was significantly raised in STEMI cases only (P = 0.09), so it may prove to be a better marker for the disease (P = 0.09). Platelet counts in various groups when compared with controls gave inconsistent results i.e SCAD vs Control significantly decreased (P = 0.07) and STEMI vs Control significantly increased (P = 0.01). Conclusion: The platelet volume indices in suspected acute coronary syndrome cases showed various changes, but present data failed to be diagnostically significant. However this data may later help to characterise further relationship between Acute coronary syndrome and platelet function in subsequent studies.

scholarly journals Prevalence of Modifiable Risk Factors among Acute Coronary Syndrome Patients in a Tertiary Care Hospital

2021 ◽  
pp. 765-772
Author(s):  
I. Mariraj ◽  
M. Naveen Kumar ◽  
N. S. Ani Rubitha ◽  
R. Rameshwar
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Diseases ◽  
Great Reduction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Coronary Syndrome

Background and Objectives: Acute Coronary Syndrome (ACS) is one of the major causes for mortality and morbidity among the cardiovascular diseases in India. In this study the modifiable risk factors leading to ACS are considered and its prevalence in a Tertiary care hospital is studied. Materials and Methods: This is a prospective type of study conducted in a tertiary care hospital. A total of 100 patients diagnosed with ACS were taken in this study. Their data was taken, and results were formulated in excel data sheet. Results: Among the UA patients, 65% were found to be dyslipidaemic, 60% as obese, 45% as diabetics, 47.5% as hypertensive and 40% as smokers. Among the NSTEMI patients, 66.67% were found to be dyslipidaemic, 52.78% as hypertensive, 44.44% as smokers, 30.56% as diabetics and 27.78% as obese. Among the STEMI patients, 37.50% were found to be dyslipidemic, 25% as both diabetic and obese, 20.83% as hypertensive,12.5% as smokers. Hypertension, dyslipidemia, smoking and obesity showed significance. Conclusion: The prevalence of modifiable risk factors is a major concern for developing ACS and when they are modified there will be a great reduction in the incidence of ACS.

Abstract 14415: Management, Characteristics, and Outcomes of Patients With Acute Coronary Syndrome in a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Muhammed K Elfaituri ◽  
Mohamed Abrahim Bin Zarti ◽  
Hazem Abdelkarem Faraj ◽  
Ahmed Khaled ◽  
Mohammed Abdulhameed Zendah ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Unstable Angina ◽  
Developing Country ◽  
Tertiary Care ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Care Hospital ◽  
Coronary Syndrome

Introduction: Acute coronary syndrome (ACS) encompasses a variety of coronary artery disorders involving myocardial infarction with ST-segment-elevation (STEMI), unstable angina (UA), and myocardial infarction with non-ST elevation (NSTEMI). Hypothesis: To gain insight into the epidemiology, evaluation, in-hospital treatment, and commitment to current management guidance of ACS for patients admitted to a tertiary care hospital in a developing country. Methods: We performed a retrospective observational study of 50 consecutive patients presenting with ACS between October 2019 and December 2019, and followed for in-hospital mortality at a tertiary care general medical unit. We collected and analysed patient reports on presentation, treatment, in-hospital mortality, and major adverse cardiovascular events (MACE). Results: Patients diagnosed with ACS had a mean (SD) age of 59.3 (13.1) years, and were predominantly men (58%). Alcohol and drug consumption, smoking, and morbid obesity were significantly associated with STEMI (P < 0.05). Discharge diagnoses included STEMI (40%), NSTEMI, and unstable angina. Mean (SD) duration of hospital stay was 5.5 (5.8) days. Left ventricular ejection fraction (LVEF) was below 40% in 28% of patients, with a mean (SD) LVEF of 46.0 (15.3) ml. Median time (interquartile range) from the onset of pain to hospital admission was 80 (423) minutes for STEMI and 138 (480) minutes for NSTEMI (P > 0.05). About 72% of patients were admitted to the cardiac intensive care unit, and 34% of STEMI patients received a fibrinolytic. All patients received anti-platelet drugs. MACE were identified in 16.3% of STEMI patients and 10.6% of NSTEMI patients. Body mass index, history of cardiac disease, longer hospital duration, diabetes, and hypertension were significant predictors of in-hospital MACE. All patients were discharged and alive at the study end. All patients received standard of care treatment after discharge. Conclusions: Delays in the delivery and application of thrombolytic are coronary therapy require attention in developing countries to improve the care of patients with ACS.

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