scholarly journals Anaemia in acute coronary syndrome: a cross-sectional study

Author(s):  
Muhammad Dilawaer Khan ◽  
Jahan Tab Qazi ◽  
Hamza Maqsood ◽  
Shaheryar Qazi ◽  
Khurram Irshad ◽  
...  

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. Present study investigates the prevalence of anaemia in ACS patients attending a tertiary health care institute.Methods: A total of 148 patients with ACS were recruited in the study from July 2018 to October 2018 in Multan institute of cardiology, Pakistan. 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 49 years. Out of 148, 114 (77%) were males and 34(23%) were females. Prevalence of anaemia was 38% in Male and 58.8% in Female. Among Male, 18.8% were microcytic, 4.54% were macrocytic and 77.27% were normocytic. Among Female, 50% were microcytic and 50%% were normocytic. Prevalence of ACS was higher is patients with diabetes and hypertension combined (31%) than in patient with diabetes alone (17.56%) or hypertension alone (21.62%). 13.51% were pure vegetarians  while 78.37% were on mixed diet consisting of vegetables+meat+pulses.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.

2017 ◽  
pp. 197-202
Author(s):  
Quang Tuan Pham ◽  
Ta Dong Nguyen ◽  
Nguyen Tuong Van Ha ◽  
Van Minh Huynh

Background: Early diagnosis in ACS is significant to treatment and prognosis. It helps to reduce death and complications. What is the value of IMA concentration for diagnosing non-ST segment elevation acute coronary syndromes. Objective: Studying the IMA concentration in blood serum in patients with non-ST segment elevation acute coronary syndromes; determining sensitivity, specificity and cut off point of IMA in diagnosis of non-ST segment elevation acute coronary syndromes. Subject and Method: 75 patients hospitalized in Hue Central Hospital with breast pang, presenting non-ST segment elevation acute coronary syndromes. Based-on the ESC Guidelines 2015, diagnosis of non-ST segment elevation acute coronary syndromes is made on 37 of those as in a patients group; 38 others are chosen as a controls group. Cross-sectional study with comparison is applied. Result: (i) Concentration of enzymes CK-MB and of hs-TnT in the patients group is higher compared with that in the controls group. Average IMA concentration in patients group is 93.49± 89.56 IU/mL (median: 58.57IU/mL) and higher compared with the controls group which reaches 15.01 ± 9.87 IU/mL (median: 11.735IU/mL). It results in a statistical significance p<0,001. (ii) The cut off point for diagnosing non-ST segment elevation acute coronary syndromes > 28.68IU/mL, reaching a sensitivity at 91.9% and a specificity at 86.8%, AUC = 0.98, 95% CI=0.95-1.00, p<0.001, OR= 74.8, 95% CI =16.54 - 338.38, p<0.001. Conclusion: IMA has high sensitivity and specificity in diagnosis of non-ST segment elevation acute coronary syndromes. Key words: iMA, NSTEMi, Acute coronary syndrome without ST elevation


2021 ◽  
Vol 17 (4) ◽  
pp. 346-360
Author(s):  
V.A. Serhiyenko ◽  
A.A. Serhiyenko

This review article summarizes the existing literature on the current state of the problem of diabetes mellitus and acute coronary syndromes. In particular, the issues are analyzed related to the etiology, epidemiology, main pathophysiological features, classification of acute coronary syndromes, acute coronary syndromes without persistent ST-segment elevation on the electrocardiogram, acute coronary syndromes with ST-segment elevation, non-athe­rosclerotic causes of acute coronary syndrome, laboratory and instrumental diagnostic tests. Issues were analyzed related to the main approaches to the treatment of acute coronary syndromes, management of patients with diabetes mellitus and acute coronary syndromes, recommendations for secondary prevention. Initial treatment with corticosteroids includes acetylsalicylic acid, bolus heparin and intravenous heparin infusion (in the absence of contraindications). Antiplatelet therapy with ticagrelor or clopidogrel is also recommended. Pain is controlled using morphine/fentanyl and oxygen in case of hypoxia. Nitroglycerin can also be used sublingually or by infusion to relieve pain. Continuous monitoring of myocardial activity for arrhythmia is required. The choice of reperfusion strategy in patients with diabetes mellitus should be based on many factors, including assessment of clinical status (hemodynamic/electrical instability, prolonged ischemia), complications of chronic coronary syndrome, ischemic load, echocardiography, assessment of left ventricular function and any other comorbidities. In addition, various methods for assessing coronary artery disease and predicting mortality due to surgery are needed to make a final decision. Advances in the sensitivity of cardiac biomarkers and the use of risk assessment tools now enable rapid diagnosis within a few hours of symptom onset. Advances in the invasive management and drug therapy have resulted in improved clinical outcomes with resultant decline in mortality associated with acute coronary syndrome.


2019 ◽  
Vol 16 (2) ◽  
pp. 63-67
Author(s):  
Navaraj Paudel ◽  
Abhishek Maskey ◽  
Dipesh Karki ◽  
Sushant Katwal ◽  
Namrata Thapa

Background and Aims: Microalbuminuria (MA) (urinary albumin excretion of 30-299 mg/d in a 24 hours collection or 30-299 μg/mg creatinine in a spot collection) is well accepted marker of micro and macrovascular damage in patients with diabetes mellitus and is considered as a surrogate marker for endothelial dysfunction in diabetic and non-diabetic patients. This study has been undertaken to investigate the prevalence of microalbuminuria among non-diabetic Acute Coronary Syndrome (ACS) patients. Methods: A hospital based cross-sectional study of 100 consecutive non-diabetic ACS patients was done. Traditional risk factors (like smoking, hypertension, dyslipidemia, obesity) of coronary artery disease were studied for the association with microalbuminuria in study subjects. Investigations were carried out in all the cases as per proforma and entered in the SPSS software for analysis. Results: The prevalence of microalbuminuria in non-diabetic ACS patients in the study was 73% which was statistically significant (p=0.04). A statistically significant higher prevalence of microalbuminuria was seen with different presentations of ACS; being highest (81.96%) in NSTEMI followed by STEMI (63.15%) and Unstable Angina (55%). It was found to be significant with the history of smoking (81.25%, p=0.013) and hypertension (82.25%, p=0.013). No significant association was found with age, body mass index (BMI) and dyslipidemia. A statistically significant higher prevalence of microalbuminuria was seen with increasing number of risk factors. Conclusion: There is increased prevalence of microalbuminuria in ACS patents. MA was associated with statistically higher number of cases with history of smoking and hypertension and presence of increasing number of risk factors.


2021 ◽  
pp. 105477382110401
Author(s):  
Audai A. Hayajneh ◽  
Mohammad Rababa ◽  
Sami Al-Rawashedeh

The prevalence of prehospital delay is high among older adults with acute coronary syndrome (ACS). The current study aimed to examine the associated factors of prehospital delay among patients with ACS during the COVID-19 pandemic. This cross-sectional study was conducted on a convenience sample of 300 older adults with ACS admitted to the emergency department in Jordan. Data were collected from June 1 to September 1, 2020. Bivariate and multivariate analyses were used to explore the predictors of prehospital delay. Being widowed, educational level, pain intensity, the gradual onset of ACS symptoms, symptoms lasting for more than 30 minutes, patients’ feeling anxious about their ACS symptoms, patients’ perceiving their symptoms to be particularly dangerous, history of myocardial infarction (MI), and mode of transportation were associated with the time taken before seeking emergency care. Significant predictors of time to seek help were chief complaint of chest pain or palpitations, abrupt onset of symptoms, the associated symptom of vertigo, and a higher number of chronic illnesses; they explained about 17.9% of the variance in the time to seek care. The average time to seek care among patients with ACS during the COVID-19 pandemic was found to be longer than the average time reported by studies conducted prior the pandemic. Improved understanding of the associations between prehospital delay is crucial for optimal ACS patient outcomes under the impacts of the COVID-19 pandemic.


Author(s):  
Amir Hossein Goudarzian ◽  
Hamid Sharif Nia ◽  
Heydar Tavakoli ◽  
Mohammad Ali Soleimani ◽  
Ameneh Yaghoobzadeh ◽  
...  

Cardiac depression is one of the most common psychological reactions of patients with acute coronary syndrome (ACS). This study aimed to determine the prevalence of cardiac depression and its related factors among patients with ACS. This cross-sectional study was conducted during 2016 in patients with ACS who were admitted to hospitals affiliated to the Mazandaran University of Medical Sciences, Iran. In the present study, 407 patients completed the Cardiac Depression Scale (CDS) within two months (March - June). The data were analyzed by a chi-square test and a general linear model multivariate analysis. According to the results, the mean cardiac depression score in patients with ACS was 109.00 ± 16.49 (CI95: 107.39 to 110.60). Among the participants, 37 (9.1%), 72 (17.7%), and 298 (73.2%) patients had mild, moderate, and severe levels of depression, respectively. Although the two-way ANOVA was not significant, but there was a difference between cardiac depression score of a type of ACS. Given the high prevalence of cardiac depression among these patients, it is necessary to develop measures for routine screening in cardiac treatment units.


2018 ◽  
Vol 2 (1) ◽  
pp. 64-72
Author(s):  
Agus Riyadi ◽  
Karmiati Karmiati

Background: Coronary heart disease is the most cardiovascular disease that causes death in the world. The ability of nurses to recognize acute coronary syndromes is very necessary as part of the emergency services team. Purpose : The purpose of this study was to determine the description of the factors that influence the ability of nurses to know acute coronary syndrome in the emergency department of dr. Iskak Tulungagung. Methods : The design of this research is descriptive analytic with a cross sectional approach with the population of all nurses who work in the Emergency Department of dr. Iskak Tulungagung. The population is 55 nurses. The sample is all of the population, namely 55 respondents with total sampling sampling techniques. The data that has been collected is processed by a statistical test of Multivariate Analysis, Ordinal Regression with significance α = 0.05. Result : The results showed that most of the respondents with D3 education were 33 respondents (60.0%), almost all respondents had never attended ECG training in the amount of 50 respondents (90.9%) and almost half of the respondents had a working period of 2-5 year is 25 respondents (45.5%). The results of the regression regression analysis showed that the p-value = 0.855 on the education factor which means that H0 was accepted, the p-value = 0.041 in the training factor which means H1 is received, the p-value = 0.003 on the working period, which means that H1 is accepted Conclusion : Based on research, education does not affect the ability to recognize acute coronary syndrome. The education obtained will develop according to the increase in the work period and the frequent training that is obtained and practiced directly in real situations


2021 ◽  
pp. 39-40
Author(s):  
Avtar Singh Dhanju ◽  
Deepshikha Singla ◽  
Pashaura Singh ◽  
Ajay Chhabra ◽  
Sukhraj Kaur

Aim: The present study was undertaken with the aim to evaluate serum Gamma Glutamyl Transferase (GGT) levels in patients of acute coronary syndrome. Methodology: This cross-sectional study was conducted on 50 cases with acute coronary syndrome (Group A) and 50 healthy control subjects (Group B) meeting inclusion and exclusion criteria. Results: There is signicant rise in serum GGT levels in patients presenting with ACS in Group A as compared to Group B. Conclusion: Higher levels of GGT in ACS patients with risk factors such as hypertension, dyslipidemia and smoking may serve as biomarker to predict the occurrence of ACS.


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