scholarly journals Evaluation of significance of melatonin and some atmospheric and heliogeophysical factors for patients with acute coronary syndrome

2017 ◽  
Vol 95 (10) ◽  
pp. 888-893
Author(s):  
Z. D. Mikhailova ◽  
Pavel F. Klimkin ◽  
M. A. Shalenkova ◽  
E. T. Manyukova ◽  
S. P. Gaidash
Keyword(s):  
Acute Coronary Syndrome ◽  
Geomagnetic Activity ◽  
Inverse Correlation ◽  
Cardiovascular Complications ◽  
Wolf Number ◽  
Cardiovascular Pathology ◽  
Coronary Syndrome ◽  
Solar Radiation Flux ◽  
Earth Magnetic Field ◽  
Heliogeophysical Factors

Introduction. Changes in melatonin (MT) production affected by earth magnetic field (EMF) were documented, including but not limited to patients with cardiovascular diseases. Thus far, the connection between MT content and atmospheric and heliogeophysical factors with regard to acute coronary syndrome (ACS) patients has not been thoroughly studied and the existing data are controversial. Material and methods. The levels of MT metabolite 6-hydroxymelatonin were measured in urine at night (MTn) and day (MTd) time in 114 ACS and 26 stable angina (SA) patients on days 1-3 of hospital stay. Results. Significant inverse correlation between MTn content and EMF H and D-components (H, D) of EMF was found in ACS patients as well as direct correlation between the MTn levels and solar radiation flux density at a wavelength of 10.7 cm (F-10.7) and the number of sun spots (the Wolf number - W). Significant direct correlation was shown between EMF D-component value, Kp- and Ap- geomagnetic activity indices in ACS patients developing cardiovascular complications. For ACS patients, the risk of development of cardiovascular complications was 1,62 and 1,15 times greater at high Kp- and Ap-indices respectively. Conclusion. Direct connection between MTn level and solar activity factors was observed in ACS patients together with inverse correlation with geomagnetic activity which confirms the influence of heliogeophysical factors on MT production. The risk of developing cardiovascular complications increases at higher Kp-and Ap- indices which proves the effect of heliogeophysical factors on the clinical course of cardiovascular pathology. The MTn content was shown to decrease in winter in these patients.

OPTIMIZATION OF THE INVASIVE STRATEGY FOR ACUTE CORONARY SYNDROME IN PATIENTS OF THE OLDER AGE GROUP

2020 ◽  
pp. 87-91
Author(s):  
А. С. Петров ◽  
В. В. Яковлев ◽  
К. Л. Козлов ◽  
В. А. Яковлев ◽  
А. В. Барсуков ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Unfractionated Heparin ◽  
Postoperative Period ◽  
Cardiovascular Complications ◽  
Older Age ◽  
Percutaneous Coronary Interventions ◽  
Age Group ◽  
Invasive Strategy ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Представлено исследование по изучению эффективности и безопасности различных антикоагулянтов, используемых у больных старшей возрастной группы с острым коронарным синдром при чрескожных коронарных вмешательствах. Показана высокая эффективность бивалирудина по сравнению с нефракционированным гепарином и Монафрамом в отношении числа кровотечений, возникающих в послеоперационном периоде, и неблагоприятных сердечно-сосудистых осложнений . A study is presented on the effectiveness and safety of various anticoagulants used in patients of an older age group with acute coronary syndrome during percutaneous coronary interventions. Bivalirudin was shown to be highly effective in comparison with unfractionated heparin and monafram in relation to the amount of bleeding that occurs in the postoperative period and adverse cardiovascular complications.

scholarly journals Association between Serum Magnesium Level with Acute Coronary Syndrome (ACS) in Diabetes Mellitus (DM) Patients

2019 ◽  
Vol 2 (2) ◽  
pp. 96
Author(s):  
Ratih Wulansari ◽  
Soebagijo Adi Soelistijo ◽  
Achmad Lefi
Keyword(s):  
Diabetes Mellitus ◽  
Acute Coronary Syndrome ◽  
Plaque Rupture ◽  
Serum Magnesium ◽  
Demographic Data ◽  
Cardiovascular Complications ◽  
Magnesium Level ◽  
Serum Magnesium Level ◽  
Coronary Syndrome ◽  
Normally Distributed

Introduction: Until now, cardiovascular complications are still the highest cause of death and disability in DM patients. Hypomagnesemia in DM accelerate atherosclerosis and can cause instability and plaque rupture which can lead to acute coronary syndrome.Methods: Design of this study was observational analytic using a "case control" study involved 76 samples of DM patients, consisting of 38 samples with SKA (+) and 38 samples with SKA (-). Subjects of this study were all DM patients in the period July-December 2018 in the Emergency Room (ER) and Outpatient Installation of Endocrine at the RSUD Dr. Soetomo Surabaya, which fulfills the criteria for inclusion and exclusion. Demographic data and clinical characteristics are presented descriptively. If data is normally distributed then an unpaired t test is carried out and if the data is not normally, distributed with Mann Whitney test is performed. The statistical test was stated to be significant if p <0.05. The association between hypomagnesemia and the incidence of ACS a multivariate logistic regression test was performed, the risk number was in the form of odds ratios (OR). Results: This study involved 76 subjects with diabetes mellitus with SKA and non SKA 38 subjects. The mean serum magnesium level in the ACS group was lower than non ACS (1.9 mg / dL vs. 2.1 mg / dL), hypomagnesemia cut-off of <2.08 mg / dL. In this study hypomagnesemia as a risk factor for the incidence of ACS in DM patients with OR 2.8 (CI 1.1-7.6; p = 0.039).Conclusion: Magnesium levels in the ACS group were lower than the non ACS group. Hypomagnesemia Increase The Incidence of Acute Coronary Syndrome in Diabetes Mellitus Patients.

scholarly journals S83. MORTALITY, REVASCULARIZATION AND CARDIOPROTECTIVE PHARMACOTHERAPY AFTER ACUTE CORONARY SYNDROME IN PATIENTS WITH PSYCHOTIC DISORDERS: A POPULATION-BASED COHORT STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S65-S66 ◽  
Author(s):  
Wing Chung Chang ◽  
Joe Kwun Nam Chan ◽  
Corine Sau Man Wong ◽  
Philip Chi Fai Or ◽  
JoJo Siu Han Hai
Keyword(s):  
Acute Coronary Syndrome ◽  
Cohort Study ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Cardiovascular Complications ◽  
Population Based ◽  
Public Healthcare ◽  
Complication Rates ◽  
Short Term ◽  
Coronary Syndrome

Abstract Background Ischemic heart disease is the leading cause of premature mortality in psychotic disorders. The authors aimed to examine short-term mortality, cardiovascular complications, revascularization and cardioprotective medication receipt after incident acute coronary syndrome (ACS) among patients with psychotic disorders compared with patients without psychotic disorders. Methods This was a population-based cohort study with data retrieved from a territory-wide medical record database of public healthcare services to 7.5 million residents in Hong Kong. The study identified 67,692 patients aged ≥18 years admitted for first-recorded ACS between January 1, 2006 and December 31, 2016. The cohort was dichotomously divided by pre-ACS diagnosis of psychotic disorder. Multivariate regression (adjusted odds ratio [aOR] and 95%CI) was used to examine associations of psychotic disorders with all-cause 30-day and 1-year mortality, cardiovascular complications, 30-day and 1-year invasive cardiac procedures, and 90-day post-discharge cardioprotective medication prescription. Results Patients with psychotic disorders (N=703) had higher 30-day (aOR=1.99, 95%CI=1.65–2.39) and 1-year (aOR=2.13, 95%CI=1.79–2.54) mortality, and cardiovascular complication rates (aOR=1.20, 95%CI=1.02–1.41), lower receipt of cardiac catheterization (30-day: aOR=0.54, 95%CI=0.43–0.68; 1-year: aOR=0.46, 95%CI=0.38–0.56), percutaneous coronary intervention (30-day: aOR=0.55, 95%CI=0.44–0.70; 1-year: aOR=0.52, 95%CI=0.42–0.63) and reduced β-blockers (aOR=0.81, 95%CI=0.68–0.97), statins (aOR=0.54, 95%CI=0.44–0.66), and clopidogrel prescriptions (aOR=0.66, 95%CI=0.55–0.80). Effect of psychotic disorder on heightened mortality was more pronounced in younger-aged (&lt;65 years) and male patients. Associations between psychotic disorder and increased mortality remained significant even after complications and treatment receipt were additionally adjusted. Discussion Psychotic disorders are associated with increased risks of short-term post-ACS mortality, cardiovascular complications and inferior treatment. Excess mortality is not substantially explained by treatment inequality. Further investigation is warranted to clarify factors for suboptimal cardiac-care and elevated mortality in psychotic disorders to enhance post-ACS outcome.

scholarly journals Assessment of the effectiveness of treatment in patients after acute coronary syndrome

2020 ◽  
Vol 25 (2) ◽  
pp. 9-18
Author(s):  
D. A. Shvets ◽  
S. V. Povetkin ◽  
A. Yu. Karasev ◽  
V. I. Vishnevsky
Keyword(s):  
Acute Coronary Syndrome ◽  
Drug Therapy ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Secondary Prevention ◽  
Generic Drugs ◽  
Myocardial Revascularization ◽  
Cardiovascular Complications ◽  
Drug Prevention ◽  
Coronary Syndrome

Aim. To assess the effectiveness of secondary drug prevention and surgical myocardial revascularization in patients with coronary artery disease (CAD) during long-term follow-up after acute coronary syndrome (ACS).Material and methods. The study involved 400 patients with ACS discharged from the hospital in 2012-2016. The diagnosis was verified according to the European Society of Cardiology (ESC) guidelines. There were no exclusion criteria. We analyzed the data of medical records (complaints, medical history, physical examination, laboratory and instrumental data). Repeated data collection was carried out by distance survey and during a face-to-face examination during 2018. According to the clinical course of CAD, all patients were divided into 2 groups. Group 1 consisted of 151 patients with complicated course of CAD, group 2 — 249 patients with stable CAD. We analyzed drug therapy recommended at hospital discharge and taken at the time of the repeated examination. The drug names and daily dosage used for the secondary prevention of CAD were recorded. Assessment of survival without cardiovascular complications was carried out according to the Kaplan-Mayer analysis.Results. Seven-year mortality was 22,5%. The total number of cardiovascular events was 37,7%. The main reason for the frequent complications was the insufficient secondary prevention of CAD after ACS. We found that the drugs and their dosage did not have a significant effect on survival. Statin use is associated with a paradoxical increase in the number of complications. The increased frequency of use and dosage of statins are a consequence of unfavorable course of CAD and do not have the proper preventive effect. For some groups of drugs, we observed irregular intake over the observation period. The low effectiveness of therapy is not only due to insufficient doses, but also in the frequent use of generic drugs. The significant effect of coronary angiography on the probability of cardiovascular complications compared with stenting is due to high proportion of coronary angiography use without revascularization.Conclusion. The combination of following factors of drug therapy can explain the low effectiveness of secondary CAD prevention: low dose (26,1±2,8 mg for atorvastatin), irregular intake and common use of generic drugs (97,6% for statins), present in different ratios. The contribution of surgical treatment to reducing cardiovascular complications is lower, the more significant residual coronary artery stenosis.

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 Peculiarities of Platelet Metabolism in Patients with Acute Coronary Syndrome with Anxiety–Depressive Disorders and Informativity of Enzymes in the Forecast of Development of Cardiovascular Complications

2020 ◽  
Vol 13 (8) ◽  
pp. 169 ◽  
Author(s):  
Natalya Yu. Shimokhina ◽  
Andrey A. Savchenko ◽  
Marina M. Petrova
Keyword(s):  
Acute Coronary Syndrome ◽  
Depressive Disorders ◽  
Cardiovascular Complications ◽  
Anaerobic Glycolysis ◽  
Coronary Syndrome ◽  
Lipid Catabolism ◽  
The Neural Network ◽  
Artery Disease ◽  
Main Clinical Manifestation

Anxiety–depressive disorders (ADD) are a risk factor of cardiovascular mortality in patients with coronary artery disease (CAD). Acute coronary syndrome (ACS) is the main clinical manifestation of a progressing CAD. Metabolic processes disorder in platelets can be one of the causes of cardiovascular complications in patients with ACS and concomitant ADD. We studied platelets metabolism and prognostic informativity of NAD(P)-dependent dehydrogenases of platelets in ACS patients with ADD in terms of forecasting cardiovascular complications development over a year of observation. The levels of NAD- and NADP-dependent dehydrogenases of platelets were determined by means of a bioluminescent method during the first 24 h after admission to hospital and in dynamics in 10 days. Among 315 examined patients, ADD was found in 161 (51.1%). ACS patients with concomitant ADD had both cytoplasmic and mitochondrial processes impairment in platelets that consisted in a decrease of energy metabolism intensity, inhibition of anaerobic glycolysis reactions and lipid catabolism. After 12 months of follow-up, 41 (25.5%) cardiovascular complications were detected in the group of ACS patients with ADD and 20 (13.0%) in the group of ACS patients without ADD. According to the results of the analysis of the neural network based on NAD(P)-dependent dehydrogenases of platelets activity in ACS patients with ADD, indicators were obtained that are informative for predicting the development of recurrent cardiovascular complications.

scholarly journals Evaluation of Drug Therapy and Adherence to It in Patients after Acute Coronary Syndrome in Real Clinical Practice (Results of One Year Observation)

2019 ◽  
Vol 14 (6) ◽  
pp. 852-857
Author(s):  
L. A. Khaisheva ◽  
S. E. Glova ◽  
V. A. Suroedov ◽  
A. S. Samakaev ◽  
S. V. Shlyk
Keyword(s):  
Acute Coronary Syndrome ◽  
Clinical Practice ◽  
Drug Therapy ◽  
Angiotensin Receptor Blockers ◽  
Coronary Event ◽  
Cardiovascular Complications ◽  
Lipid Lowering ◽  
Hospital Treatment ◽  
Coronary Syndrome ◽  
Real Clinical Practice

Aim. To study the prescribed drug therapy, as well as adherence to it in patients with acute coronary syndrome (ACS) in real clinical practice within a year after the index event. Material and methods. The study included 327 patients who were in hospital treatment with ACS: 199 patients (60.9%) with unstable angina (UA) and 128 (39.1%) – with acute myocardial infarction (AMI). The prescribed treatment and adherence to therapy were evaluated within 12 months after the coronary event. Therapy prescribed to patients was compared with current clinical guidelines for the treatment of patients with ACS. Results. 67% of patients completed the clinical study Adherence to prescribed medication within 12 months after ACS was maximal for ACE inhibitors/angiotensin receptor blockers (83.6%), dual antiplatelet therapy (79.9%) and β-blockers (78.1%), and minimal for lipid-lowering drugs (statins; 61.6%). A significant decrease in adherence was revealed in 6 and 12 months from the initiation of therapy. Significantly higher level of adherence to DAT was found in patients with AMI compared with patients with UA (p<0.05). When analyzing the frequency of occurrence of endpoints, it was found that patients who did not adhere to treatment significantly more often had hospitalizations due to UA (15.1% vs 7.4%; p<0.05), AMI (16.9% vs 8.1%; p<0.05), death from cardiovascular causes (13% vs 10.4%; p<0.05). Conclusion. Therapy prescribed at the outpatient stage in patients with ACS in the Rostov Region corresponds to the modern clinical recommendations. Six months after hospital discharge adherence to drug therapy in patients is reduced, which requires more careful outpatient monitoring during this period. In patients who are not adherent to treatment, cardiovascular complications are significantly more frequent.

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