Comparative gender and age characteristics of patients with acute coronary syndrome according to the data of the Cardiac Surgery Unit of an Emergency Hospital and the Bureau of Forensic Medical Examination

2021 ◽  
Vol 1_2021 ◽  
pp. 43-47
Author(s):  
Pigolkin Yu.I. Pigolkin ◽  
Kolomoets I.A. Kolomoets ◽  
Berezovsky D.P. Berezovsky ◽  
Kolbasin A.V. Kolbasin A ◽  
Bachurin S.S. Bachurin ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Surgery ◽  
Medical Examination ◽  
Emergency Hospital ◽  
Coronary Syndrome ◽  
Gender And Age

scholarly journals Experience in implementing a regional registry of patients with acute coronary syndrome

2020 ◽  
Vol 27 (4) ◽  
pp. 54-61
Author(s):  
L. V. Rasputina ◽  
D. V. Didenko ◽  
A. V. Solomonchuk
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Middle Age ◽  
Artery Bypass ◽  
Inverse Correlation ◽  
Family Doctors ◽  
Coronary Syndrome ◽  
Gender And Age

The aim – to create a regional registry of patients who have suffered an acute myocardial infarction (AMI), to determine the frequency of endpoints: death, recurrent myocardial infarction, recurrent coronary angiography (CA), coronary artery bypass grafting (CABG), acute cerebrovascular accident (ACVA), bleeding, hospitalization after MI.Materials and methods. 33 centers of Vinnytsya and Vinnytsya region were involved in the study. During the period 2017–2018, 2120 patients of middle age 75.9±7.7 years were included in the register. Among them 1361 (64.2 %) men, middle age 67.5±8.4 years and 759 (35.8 %) women, middle age 76.3±8.2 years. There were 1658 patients with Q-MI and 462 (21.8 %) patients with MI without Q-wave.Results and discussion. It was found that after discharge from the hospital 419 people (13.4 %) did not visit family doctors and cardiologists. Among them were 262 (62.5 %) men and 157 (37.5 %) women. These patients did not differ significantly in gender and age structure from those who were under medical supervision. In both groups, men predominated and there were significantly more people over the age of 60. Twelve months after AMI, 37 (1.7 %) cases of CABG were documented among patients who visited doctors, 29 patients (1.4 %) were diagnosed with ACVA, and 101 patients (4.8 %) were hospitalized for recurrent AMI and 156 people (7.4 %) underwent CA. In patients with interventional AMI treatment tactics, there were significantly fewer cases of recurrent MI (p=0.022), hospitalization (p=0.025) and death (р<0,001) within 12 months. In patients with AMI, an inverse correlation was found between age and mortality, hospitalized bleeding, and CA. The connection between the fact of performing prehospital thrombolysis and hospitalization for heart failure during the year after AMI was determined. There is a negative correlation between CA and hospitalization for heart failure, bleeding that required hospitalization, re-CA and ACVA.Conclusions. Among patients treated for acute coronary syndrome, 13.4 % do not seek outpatient medical care after discharge from the hospital. Among them are significantly more men, people over 60 years old, residents of countryside. Twelve months after AMI, 1.7 % of patients undergo CABG, 1.4 % are diagnosed with ACVA, and 1.7 % have bleeding that requires hospitalization. 25.7 % of patients are re-hospitalized during the year, 9.5 % die. Among patients who undergo emergency CA and coronary artery stenting, there are more people who have CABG and who have been diagnosed with bleeding that requires hospitalization. In this group, there is a significant reduction in cases of recurrent MI, hospitalizations and deaths during the year.

scholarly journals Under-24-hour mortality from acute coronary syndrome in emegrency hospital

2012 ◽  
Vol 93 (6) ◽  
pp. 859-864
Author(s):  
Z G Valeev ◽  
V G Belyakov ◽  
L Y Salyahova
Keyword(s):  
Acute Coronary Syndrome ◽  
Female Mortality ◽  
Total Rate ◽  
Emergency Hospital ◽  
Coronary Syndrome ◽  
Factors Influencing ◽  
Complex Approach ◽  
Mortality Ratio ◽  
The Impact ◽  
Male To Female

Aim. To identify the factors influencing the strategy and tactics of treating patients with acute coronary syndrome; to define the impact of various stages of emergency care in total rate of under-24-hour in-patients mortality. Methods. The retrospective analysis of the in-patients medical charts, ambulance accompanying sheets and autopsy protocols of 303 patients who died during the first 24 hours after admission to the department of cardiology at Municipal Emergency Hospital №1, Kazan from January 1st, 2009 to December 31th, 2011. Results. The level of under-24-hour in-patients mortality in the emergency hospital remains considerably high without a tendency to fall. In economically active group of population male to female mortality ratio exceeds 1,8. Most patients are being brought to the hospital by ambulance crews which are not enough qualified and equipped to care for patients in a critical condition. Only 48.3% of admitted patients get medical aid before admission, although the share of patients admitted in a poor, critical or agonal condition is 89.8%. Conclusion. Decreasing under-24-hour mortality is a multidimensional and multifactorial problem, which demands a complex approach in all stages of providing medical care to be solved.

scholarly journals Posttraumatic Stress Disorder after Acute Coronary Syndrome or Cardiac Surgery; Underestimated Reality

2020 ◽  
Vol 15 (1-2) ◽  
pp. 3-8
Author(s):  
Nenad Lakušić ◽  
Gordana Kamenečki ◽  
Ivana Sopek Merkaš ◽  
Duško Cerovec ◽  
Krunoslav Fučkar ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Acute Coronary Syndrome ◽  
Cardiac Surgery ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Coronary Syndrome

scholarly journals Age as a Prognostic Factor in Patients with Acute Coronary Syndrome undergoing Urgent/Emergency Cardiac Surgery

2015 ◽  
Vol 24 (9) ◽  
pp. 845-853
Author(s):  
Elena Crudeli ◽  
Chiara Lazzeri ◽  
Pierluigi Stefàno ◽  
Marco Chiostri ◽  
Claudio Blanzola ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Surgery ◽  
Prognostic Factor ◽  
Coronary Syndrome

scholarly journals Usefulness of troponin in selecting patients for invasive coronary angiography after cardiac surgery

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Omran ◽  
M.A Deutsch ◽  
E Groezinger ◽  
A Renner ◽  
J Neumann ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Surgery ◽  
Coronary Angiography ◽  
Predictive Value ◽  
Primary Outcome ◽  
Invasive Coronary Angiography ◽  
High Sensitivity ◽  
Exclusion Criteria ◽  
Coronary Syndrome ◽  
Cabg Patients

Abstract Background Great uncertainty exists about the indication for invasive coronary angiography (ICA) in patients with suspected acute coronary syndrome following cardiac surgery. Aim The aim of this study was to define clinical criteria that best identify patients who benefit from ICA after cardiac surgery. Methods We performed a retrospective analysis of all patients who underwent cardiac surgery between January 2009 and May 2019 at our center. Exclusion criteria included pediatric patients as well as pacemaker, TAVR and LVAD implantation and heart transplantation procedures. The primary outcome was usefulness of ICA as defined by consequent PCI or re-operation due to ICA findings. ECG changes (ST-elevations) and high-sensitivity Troponin I (hsTrop I) were analyzed. Results 48,136 patients were screened and after applying exclusion criteria 29,359 patients were finally included in the analysis (mean age 67.8±11.0 years, 31.1% females, Euroscore II 5.14±8.9%). A total of 1,171 patients (4%) underwent post-op ICA. The primary outcome occurred in 440 patients (1.5%) of which 290 underwent consequent PCI and 214 underwent consequent re-operation. Baseline characteristics are shown in table 1. Unadjusted analyses did not identify significant differences in the level of cardiac biomarkers between useful-ICA and unuseful-ICA groups. In multivariate regression analysis, only ST-elevation on ECG predicted the primary outcome (OR 1.33, 95% CI 1.003–1.76). Dichotomizing hsTrop I concentrations by applying the guideline-specified cut-off (&gt;70x URL) resulted in correct classification of useful-ICA patients in 95.7%. However, the false-positive rate was also extremely high (83.6%) with a positive predictive value (PPV) of 1.6% and a negative predictive value (NPV) of 99.6% (accuracy 17.5%). Using area under the curve (ROC) analysis following optimal cut-off values for hsTrop I were identified: in CABG patients a cut-off value of &gt;650x URL (corresponding absolute value 17000 ng/L) was defined with a corresponding sensitivity of 83.3%, specificity of 83.6%, PPV of 8.9% and NPV of 99.6% (accuracy 83.6%). In non-CABG patients (i.e. valve or aortic procedures), the cut-off was about twice as high as that for CABG patients (1,350x URL or 35,000 ng/L) with a corresponding sensitivity of 84.1%, specificity of 89.2%, PPV of 5.9% and NPV of 99.9% (accuracy 89.1%). Conclusion Our study demonstrates that currently recommended cut-off concentrations of high-sensitivity troponin are not useful for guiding clinical decision-making in patients with suspected acute coronary syndrome following cardiac surgery, while substantially higher cut-off values might be useful. Those cut-off values critically depend on the type of cardiac surgery performed (CABG vs. non-CABG). Troponin_Curves post-op Funding Acknowledgement Type of funding source: None

scholarly journals Prevalence of digestive diseases in patients with acute coronary syndrome

2020 ◽  
pp. 88-94
Author(s):  
O. A. Naumova ◽  
L. A. Efros ◽  
O. F. Kalev
Keyword(s):  
Acute Coronary Syndrome ◽  
Digestive System ◽  
Clinical Form ◽  
Coronary Syndrome ◽  
The Third ◽  
Digestive Diseases ◽  
Cardiology Department ◽  
Number Of Patients ◽  
Gender And Age ◽  
Gastroduodenal Zone

Purpose of the study. To study the prevalence of digestive diseases in patients with acute coronary syndrome.Materials and methods. A retrospective study included 1079 patients with acute coronary syndrome who were treated in the cardiology department No. 2 of the Chelyabinsk Regional Clinical Hospital in 2015. After further examination, the diagnosis of acute coronary syndrome was withdrawn in 40 patients (3.7%). In the future, this group was not studied due to the small number of patients. Of the group of patients with acute coronary syndrome (n = 1039 people), patients were distributed taking into account gender and age, of which 679 (65.4%) were men, 360 (34.6%) were women. The average age of all patients was (61.9 ± 11.9) years, men (58.9 ± 11.9) years, women (67.6 ± 12.0) years. Statistical analysis was performed using Microsoft Offi ce applications and SPSS Statistics programs (version 21.0).Results. Among all concomitant diseases in patients with acute coronary syndrome, digestive diseases take the third place. Among the risk factors in patients with acute coronary syndrome and digestive diseases, hypertension and hypercholesterolemia were most often recorded. Multivascular damage to the coronary arteries was more often observed in patients with myocardial infarction in the presence of digestive diseases. At the time of discharge from the hospital in patients with acute coronary syndrome in the presence of diseases of the gastroduodenal zone, monotherapy (clopidogrel / ticagrelor) was recommended three times more often in comparison with the group without digestive diseases. Inhibitors of the proton pump (omeprazole) in the presence of pathology of the digestive system are recommended in almost 100% of cases, regardless of the clinical form of acute coronary syndrome. 

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