scholarly journals Anaemia in acute coronary syndrome patients: a study from rural tertiary care centre of India

2018 ◽  
Vol 6 (8) ◽  
pp. 2677
Author(s):  
Vivek Kumar Verma ◽  
Durga Prasad Singh ◽  
Dheeraj Kela ◽  
V. Vijayavarman ◽  
Geeta Singh
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Blood Loss ◽  
Unstable Angina ◽  
Acute Coronary Syndromes ◽  
Vitamin B12 Deficiency ◽  
Coronary Syndrome ◽  
B12 Deficiency ◽  
Coronary Syndromes ◽  
St Elevation

Background: Acute coronary syndromes (ACS) are an imbalance between myocardial oxygen supply and demand, and the presence of anaemia further potentiates this imbalance. The burden of anaemia in patients presenting with acute coronary syndromes (ACS) is significant. Anaemia has the potential to worsen myocardial ischemic insult by decreasing the oxygen content of the blood supplied to the jeopardized myocardium.Methods: A total of 148 patients with ACS were recruited in the study from October 2016 to December 2017 in Medicine and Cardiology Department of UPUMS Saifai, India. All patients were subjected to a detailed history and thorough clinical examination and investigations after obtaining informed consent. Patient having any other diseases known to cause anaemia were excluded.Results: Mean age of patients was 58.5 years. 72.97% were vegetarian and 27.03% were non-vegetarian. Most common morphological type of anaemia was dimorphic anaemia followed by macrocytic and microcytic hypochromic respectively. Iron deficiency anaemia was most common type of anaemia followed by vitamin B12 deficiency and mixed (Iron and vitamin B12 deficiency). 45.28% anaemic patients had no symptoms of blood loss. Most common symptom of blood loss was bleeding per rectum followed by malena. Severity of acute coronary syndrome was more in subjects having anaemia which was evident by higher incidence of anaemia in subjects having ST elevation myocardial infarction (STEMI). The incidence of anaemia was low in case of Non ST elevation Myocardial Infarction (NSTEMI) and Unstable angina (UA). The results of the present study have been compared to those from India.Conclusions: Higher incidence of anaemia was reported in subjects having acute coronary syndrome. Incidence of anaemia in STEMI patients was greater than NSTEMI and unstable angina patients. Severe form of acute coronary syndrome i.e. STEMI was associated with higher incidence of anaemia. 

scholarly journals Antiplatelet Therapy in Acute Coronary Syndrome

2017 ◽  
Vol 12 (1) ◽  
pp. 33 ◽  
Author(s):  
Kerry Layne ◽  
Albert Ferro ◽  
◽  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Unstable Angina ◽  
Acute Coronary Syndromes ◽  
Clinical Evidence ◽  
Drug Class ◽  
Antiplatelet Agents ◽  
Pharmacological Properties ◽  
Coronary Syndrome ◽  
Coronary Syndromes

Antiplatelet agents have for decades been used to improve outcomes in patients with acute coronary syndromes and have become increasingly valued, not only for their antithrombotic properties but also for their anti-inflammatory effects. The drug class continues to evolve as novel agents with increasingly efficacious antiplatelet actions are identified. This review will discuss antiplatelet agents, including aspirin, the P2Y12 receptor antagonists and the glycoprotein IIb/IIIa inhibitors, that are currently used to treat patients with unstable angina and myocardial infarction, focusing on their pharmacological properties and the clinical evidence supporting their use.

Anti-Platelet and Anti-Thrombotic Therapy Post-AMI

2011 ◽  
Author(s):  
Dana Dawson ◽  
Keith Fox
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Myocardial Reperfusion ◽  
St Elevation Myocardial Infarction ◽  
Coagulation Cascade ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation

• Acute coronary syndromes (ACS) encompass a spectrum of presentations which include unstable angina, non-ST-elevation myocardial infarction (NSTEMI or NSTE-ACS), and ST-elevation myocardial infarction (STEMI or STE-ACS)• Anti-platelet and anti-thrombotic agents are administered as ancillary therapy to myocardial reperfusion in patients presenting with an acute coronary syndrome, to maintain the patency of the infarct-related coronary artery• More specific and potent inhibitors of platelet activation and of the coagulation cascade are emerging with the aim being to further improve clinical outcomes in patients presenting with an acute coronary syndrome, without increasing the risks of major bleeding.

scholarly journals The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS): Design and Methodology

2021 ◽  
Vol 11 (2) ◽  
pp. 84-97
Author(s):  
Malcolm. E. Legget ◽  
Vicky. A. Cameron ◽  
Katrina. K. Poppe ◽  
Sara Aish ◽  
Nikki Earle ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
New Zealand ◽  
Acute Coronary Syndromes ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Prospective Longitudinal ◽  
First Time

Background. Each year, approximately 5000 New Zealanders are admitted to hospital with first-time acute coronary syndrome (ACS). The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) is a prospective longitudinal cohort study embedded within the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry in six hospitals. The objective of MENZACS is to examine the relationship between clinical, genomic, and cardiometabolic markers in relation to presentation and outcomes post-ACS. Methods. Patients with first-time ACS are enrolled and study-specific research data is collected alongside the ANZACS-QI registry. The research blood samples are stored for future genetic/biomarker assays. Dietary information is collected with a food frequency questionnaire and information about physical activity, smoking, and stress is also collected via questionnaire. Detailed family history, ancestry, and ethnicity data are recorded on all participants. Results. During the period between 2015 and 2019, there were 2015 patients enrolled. The mean age was 61 years, with 60% of patients aged <65 years and 21% were female. Ethnicity and cardiovascular (CV) risk factor distribution was similar to ANZACS-QI: 13% Māori, 5% Pacific, 5% Indian, and 74% NZ European. In terms of CV risk factors, 56% were ex-/current smokers, 42% had hypertension, and 19% had diabetes. ACS subtype was ST elevation myocardial infarction (STEMI) in 41%, non-ST elevation myocardial infarction (NSTEM) in 54%, and unstable angina in 5%. Ninety-nine percent of MENZACS participants underwent coronary angiography and 90% had revascularization; there were high rates of prescription of secondary prevention medications upon discharge from hospital. Conclusion. MENZACS represents a cohort with optimal contemporary management and will be a significant epidemiological bioresource for the study of environmental and genetic factors contributing to ACS in New Zealand’s multi-ethnic environment. The study will utilise clinical, nutritional, lifestyle, genomic, and biomarker analyses to explore factors influencing the progression of coronary disease and develop risk prediction models for health outcomes.

scholarly journals Anaphylaxis from Wasp Stings Inducing Coronary Thrombus

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Sazzli Kasim ◽  
Rafidah AbuBakar ◽  
Eugene McFadden
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Acute Coronary Syndromes ◽  
Mast Cell Degranulation ◽  
Kounis Syndrome ◽  
Coronary Syndrome ◽  
Rare Manifestation ◽  
Coronary Syndromes ◽  
Wasp Stings ◽  
Allergic Angina

Myocardial infarction as a result of wasp stings is a rare manifestation of acute coronary syndromes. It has been ascribed to kounis syndrome or allergic angina whose triggers include mast cell degranulation leading to coronary vasospasm and/or local plaque destabilisation. Its exact pathophysiology is still not clearly defined. We present a case of an acute coronary syndrome as a consequence of wasp stings and discuss its possible aetiology.

scholarly journals Surgical revascularization for acute coronary syndromes: a report from the North Rhine-Westphalia surgical myocardial infarction registry

2020 ◽  
Vol 58 (6) ◽  
pp. 1137-1144
Author(s):  
Oliver J Liakopoulos ◽  
Ingo Slottosch ◽  
Daniel Wendt ◽  
Hendryk Welp ◽  
Wolfgang Schiller ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
Acute Coronary Syndromes ◽  
Left Ventricular Ejection ◽  
Logistic Euroscore ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Coronary Syndromes ◽  
St Elevation

Abstract OBJECTIVES The aim of this was to analyse current outcomes in patients referred to coronary artery bypass grafting (CABG) for acute coronary syndromes (ACSs), including ST-elevation or non-ST-elevation ACS (non-ST-segment elevation myocardial infarction) or unstable angina. METHODS Patients (n = 2432) undergoing CABG for ACS between January 2010 and December 2017 were prospectively entered into a surgical myocardial infarction registry in North Rhine-Westphalia, Germany. Key end points were in-hospital all-cause mortality (IHM) and major adverse cardio-cerebral events (MACCE). Predictors for IHM and MACCE were analysed by multivariable logistic regression. RESULTS Patients (78% males) were referred for CABG for unstable angina (25%), non-ST-segment elevation myocardial infarction (50%), and ST-segment elevation myocardial infarction (25%). The mean patient age was 68 ± 11 years, logistic EuroSCORE was 19 ± 18% and three-vessel and left main stem diseases were diagnosed in 81% and 45% of patients, respectively. On-pump CABG with cardiac arrest or beating heart was performed in 92% and 2%, respectively, with only 6% off-pump surgery and 6% multiple arterial revascularization (3.1 ± 1.0 grafts, 93% left internal thoracic artery). Emergency CABG was performed in 23% of patients (42% in ST-segment elevation myocardial infarction; P &lt; 0.001). The total IHM and MACCE rates were 8.1% and 17.5% and were highest in ST-segment elevation myocardial infarction patients with 12.6% and 28.5%, respectively (P &lt; 0.001). Key predictors for IHM and MACCE were female gender, elevated troponin, left ventricular ejection fraction, inotropic support, logistic EuroSCORE, cardiopulmonary bypass and aortic clamp time and the need for emergency CABG. CONCLUSIONS Surgical myocardial revascularization in patients with ACS is still linked to substantial in-hospital mortality. Emergency CABG for patients with ACS was associated with poorer outcomes.

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