Basic Clinical Characteristics and Hospital Outcomes of Acute Coronary Syndrome Patients-Sudan

Background: There are Variation in the presentation of the acute coronary syndrome between countries. The present study aimed to investigate the basic clinical characteristics and in-hospital outcomes among acute coronary syndrome patients in the Sudan.Material and Methods: A cross-sectional comparative study conducted among 202 consecutive acute coronary syndrome patients at a reference coronary care unit in Omdurman Teaching Hospital between July 2014 and August 2015. Participants signed a written informed consent, and then a case report form was filled. Information collected include vascular risk factors, vital signs, echocardiographic findings, and in Hospital complications. The local ethical committee approved the research, and the chi-square test was used to compare ST-segment Elevation (STSEACS) and None ST-Segment Elevation Acute coronary syndrome (NSTSEACS).Results: (out of 202 women (53.75%) in (NSEACS) P =0.009). Prior myocardial infarction, hypertension, diabetes mellitus, and, smoking were evident in 19.8%. 53.%, 30.2%, and 16.6% of acute coronary syndrome respectively, 97% of patients presented with chest pain, 54% presented to the hospital after 24 hours. Hypotension, heart failure, low ejection fraction, and in-hospital complications were more in (STSEACS) than (NSTSEACS), while (NSTEACS) patients received less Thrombolysis and Percutaneous coronary angioplasty P-value < 0.05Conclusions: Acute coronary syndrome patients were younger and had more complications than others in the West. ST-Segment Elevation Myocardial Infarction Patients are more likely to develop in-hospital complications and to receive reperfusion therapy. The limitation of the study is the lack of follow-up information after discharge.

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Relation between Major and Minor Depression and Heart Rate, Heart-Rate Variability, and Clinical Characteristics of Patients with Acute Coronary Syndrome

Psychological Reports ◽

10.2466/pr0.100.4.1245-1254 ◽

2007 ◽

Vol 100 (3_suppl) ◽

pp. 1245-1254 ◽

Cited By ~ 6

Author(s):

Katija Čatipović-Veselica ◽

Andrea Galić ◽

Krešimir Jelić ◽

Vedrana Baraban-Glavaš ◽

Sandra Šarić ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Rate ◽

Heart Rate Variability ◽

Acute Coronary Syndrome ◽

Clinical Characteristics ◽

Minor Depression ◽

St Segment Elevation ◽

Coronary Syndrome ◽

Segment Elevation Myocardial Infarction ◽

St Segment

This study examined the prevalence of major and minor depression in patients with acute coronary syndrome and their relation with heart rate and heart-rate variability, and clinical characteristics. The study group included 297 patients, 200 men and 97 women, between ages of 21 and 70 years ( M age = 57.5 ± 9.6), who were admitted to a coronary care unit with acute coronary syndrome and survived to discharge from the hospital. Major and minor depression were diagnosed using DSM-IV. There were 44.1% patients with acute coronary syndrome without depression, 29.3% with minor depression, and 26.6% with major depression. The prevalence of minor and major depression was more elevated in patients with non-ST-segment elevation myocardial infarction and unstable angina than in patients with ST-segment elevation myocardial infarction. Ventricular fibrillation and atrial fibrillation were more common in patients with major and minor depression than in patients without depression. The 24-hr. duration of heart-beat intervals and heart-rate variability were significantly lower in patients with major and minor depression than in patients without depression. This study implies that clinical depression was significantly comorbid with the acute coronary syndrome and was related to hypertension, diabetes mellitus, age, sex, type of acute coronary syndrome, left ventricular failure, higher heart rate, and lower heart-rate variability.

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Clinical characteristics and long-term progression of young patients with acute coronary syndrome in Brazil

Einstein (São Paulo) ◽

10.1590/s1679-45082015ao3381 ◽

2015 ◽

Vol 13 (3) ◽

pp. 370-375 ◽

Cited By ~ 14

Author(s):

Alexandre de Matos Soeiro ◽

Felipe Lourenço Fernandes ◽

Maria Carolina Feres de Almeida Soeiro ◽

Carlos Vicente Serrano Jr ◽

Múcio Tavares de Oliveira Jr

Keyword(s):

Acute Coronary Syndrome ◽

Clinical Characteristics ◽

Young Patients ◽

Coronary Bypass ◽

Percutaneous Coronary Angioplasty ◽

St Segment Elevation ◽

Coronary Syndrome ◽

St Segment

Objective In Brazil, there are few descriptions in the literature on the angiographic pattern and clinical characteristics of young patients with acute coronary syndrome, despite the evident number of cases in the population. The objective of this study was to evaluate which clinical characteristics are most closely related to the acute coronary syndrome in young patients, and what long-term outcomes are in this population.Methods This is a prospective observational study with 268 patients aged under 55 years with acute coronary syndrome, carried out between May 2010 and May 2013. Data were obtained on demographics, laboratory test and angiography results, and the coronary treatment adopted. Statistical analysis was presented as percentages and absolute values.Results Approximately 57% were men and the median age was 50 years (30 to 55). The main risk factors were arterial hypertension (68%), smoking (67%), and dyslipidemia (43%). Typical pain was present in 90% of patients. In young individuals, 25.7% showed ST segment elevation. Approximately 56.5% of patients presented with a single-vessel angiographic pattern. About 7.1% were submitted to coronary bypass surgery, and 42.1% to percutaneous coronary angioplasty. Intrahospital mortality was 1.5%, and the combined event rate (cerebrovascular accident/stroke, cardiogenic shock, reinfarction, and arrhythmias) was 13.8%. After a mean follow-up of 10 months, mortality was 9.8%, while 25.4% of the patients had new ischemic events, and 37.3% required readmission to hospital.Conclusion In the short-term, young patients presented with mortality rates below what was expected when compared to the rates noted in other studies. However, there was a significant increase in the number of events in the 10-month follow-up.

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Analysis of risk factors for different subtypes of acute coronary syndrome

Journal of International Medical Research ◽

10.1177/03000605211008326 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110083

Author(s):

Lei Zhang ◽

Juledezi Hailati ◽

Xiaoyun Ma ◽

Jiangping Liu ◽

Zhiqiang Liu ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Brain Natriuretic Peptide ◽

Left Ventricular ◽

St Segment Elevation ◽

Amino Terminal ◽

Coronary Syndrome ◽

Segment Elevation Myocardial Infarction ◽

St Segment

Aims To investigate the different risk factors among different subtypes of patients with acute coronary syndrome (ACS). Methods A total of 296 patients who had ACS were retrospectively enrolled. Blood and echocardiographic indices were assessed within 24 hours after admission. Differences in risk factors and Gensini scores of coronary lesions among three groups were analyzed. Results Univariate analysis of risk factors for ACS subtypes showed that age, and levels of fasting plasma glucose, amino-terminal pro-brain natriuretic peptide, and creatine kinase isoenzyme were significantly higher in patients with non-ST-segment elevation myocardial infarction (NSTEMI) than in those with unstable angina pectoris (UAP). Logistic multivariate regression analysis showed that amino-terminal pro-brain natriuretic peptide and the left ventricular ejection fraction (LVEF) were related to ACS subtypes. The left ventricular end-diastolic diameter was an independent risk factor for UAP and ST-segment elevation myocardial infarction (STEMI) subtypes. The severity of coronary stenosis was significantly higher in NSTEMI and STEMI than in UAP. Gensini scores in the STEMI group were positively correlated with D-dimer levels (r = 0.429) and negatively correlated with the LVEF (r = −0.602). Conclusion Different subtypes of ACS have different risk factors. Our findings may have important guiding significance for ACS subtype risk assessment and clinical treatment.

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Clots Kill: Hematologic Pharmacology for ST-Segment Elevation Myocardial Infarction

Critical Care Nurse ◽

10.4037/ccn2012104 ◽

2012 ◽

Vol 32 (6) ◽

pp. 35-41

Author(s):

Stacy H. James

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Antiplatelet Agents ◽

Thrombin Inhibitors ◽

Fibrinolytic Agents ◽

St Segment Elevation ◽

Coronary Syndrome ◽

Segment Elevation Myocardial Infarction ◽

St Segment

Drugs that work on the hematologic system play an important role in helping to limit the morbidity and mortality that can be associated with an acute coronary syndrome. The pharmacology of the fibrinolytic agents, thrombin inhibitors, and antiplatelet agents is described. A case study of a woman having an ST-segment elevation myocardial infarction is reviewed to highlight the importance of drugs that work on the hematologic system.

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Abstract 12762: Clinical Characteristics and Determinants of Non-Eligibility for Reperfusion in Patients With ST Segment Elevation Myocardial Infarction: Insights From the NCDR®

Circulation ◽

10.1161/circ.130.suppl_2.12762 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Tarun W Dasari ◽

Steve Hamilton ◽

Anita Y Chen ◽

Tracy Y Wang ◽

James A de Lemos ◽

...

Keyword(s):

Myocardial Infarction ◽

Clinical Characteristics ◽

Major Contributor ◽

Primary Pci ◽

Hospital Outcomes ◽

St Segment Elevation ◽

Vessel Disease ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

St Elevation

Background: There is little recent data describing the characteristics and outcomes of STEMI patients who do not undergo urgent reperfusion. Methods: Using the ACTION Registry®-GWTG™ database, we examined 232,208 STEMI patients presenting January 2007 through December 2013 at 793 U.S. centers. The cohort was divided into those who underwent reperfusion (n=194,916; 84%), had documented contraindication to reperfusion (n=31,518; 13.5%) and were eligible but not reperfused (n=5,774; 2.5%). Clinical characteristics and in-hospital outcomes were compared between these groups. Results: Compared with those reperfused, patients not reperfused were older, more often female and had higher rates of hypertension, diabetes, MI, stroke and atrial fibrillation. LBBB and CHF were more common in the non-reperfused groups upon presentation. The major documented contraindications to reperfusion were unsuitable anatomy for primary PCI (31%), symptoms onset > 12 hours (9%), patient/family refusal/DNR status (6%), resolved chest pain (6%) and ST elevation (5%) presentation to non-PCI centers (4%). Three-vessel disease and in-hospital CABG were more common in non-reperfused patients with and without contraindication compared with those receiving reperfusion (39 & 37% vs. 26%, p<0.001) and (17 & 17% vs. 3%, p<0.001 respectively). In-hospital outcomes are summarized in the table. Conclusion: Most STEMI patients who were not reperfused had a documented contraindication. Unsuitable anatomy for PCI was the major contributor to ineligibility. In hospital mortality, death/MI and cardiogenic shock were higher in the non-reperfused groups.

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Abstract 2602: Elevated Serum Neopterin Levels and Adverse Cardiac Events in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome

Circulation ◽

10.1161/circ.116.suppl_16.ii_576-b ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Juan Carlos Kaski ◽

Luciano Consuegra-Sanchez ◽

Daniel J. Fernandez-Berges ◽

Jose M Cruz-Fernandez ◽

Xavier Garcia-Moll ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Unstable Angina ◽

Elevated Serum ◽

Cardiac Events ◽

St Segment Elevation ◽

Coronary Syndrome ◽

St Segment ◽

Adverse Cardiac Events ◽

Elevation Acute Coronary Syndrome

Objectives: We sought to assess whether plasma neopterin predicts adverse clinical outcomes in patients with NSTEACS. Background: Circulating C reactive protein (CRP), a marker of inflammation, correlates with events in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). High neopterin levels - a marker of macrophage activation - predict cardiovascular events in stable angina patients but their prognostic role in NSTEACS has not been systematically evaluated. Methods: We prospectively assessed 397 patients (74 % men) admitted with NSTEACS: 169 (42.5%) had unstable angina and 228 (57.5%) non-ST-segment elevation myocardial infarction (NSTEMI). Blood samples for neopterin and CRP assessment were obtained at admission. TIMI risk score was also assessed among other clinical and biochemical variables. The study end point was the composite of cardiac death, acute myocardial infarction and recurrent angina at 180-days. Results: Baseline neopterin concentrations (nmol/L) were similar in unstable angina and NSTEMI patients (8.3 [6.5–10.6] vs 8.0 [6.2–11.1], p = 0.54). Fifty-nine patients (14.9 %) had events during follow-up (highest third (%) 21.5 vs 1 st and 2 nd thirds 11.5, log rank 7.341, p = 0.007). On multivariable hazard Cox regression, only neopterin (highest vs 1 st and 2 nd thirds, HR 2.15, 95 % CI [1.21–3.81]) was independently associated with the combined endpoint.CRP levels, however, were not significantly different in patients with events compared to those without events (adjusted HR = 0.98, p = 0.89, 95% CI 0.80 –1.21). Conclusion: Increased neopterin levels are an independent predictor of 180-day adverse cardiac events in patients with NSTEACS.

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Modern strategy of drug treatment of patients with myocardial infarction without ST segment elevation

Medical Science And Education Of Ural ◽

10.36361/1814-8999-2021-22-3-90-93 ◽

2021 ◽

Vol 22 (3) ◽

pp. 90-93

Author(s):

L. V. Kremneva ◽

◽

O. V. Abaturova ◽

N. Yu. Stogniy ◽

S. N. Suplotov ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Drug Therapy ◽

Literature Review ◽

Drug Treatment ◽

Modern Approach ◽

St Segment Elevation ◽

Coronary Syndrome ◽

St Segment

The modern approach to the treatment of patients with acute coronary syndrome without ST segment elevation on electrocardiogram (NSTEMI) involves the implementation of invasive interventions and the appointment of drug therapy. This literature review presents data on the features of drug treatment of patients with NSTEMI.

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