scholarly journals Myocardial Revascularization in COVID-19 Era

2021 ◽  
Vol 2 (3) ◽  
pp. 1-4
Author(s):  
Sasmojo Widito
Keyword(s):  
Acute Coronary Syndrome ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Benefit ◽  
Healthcare Professionals ◽  
Myocardial Revascularization ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Coronary Syndrome ◽  
Need To Evaluate ◽  
Benefit And Risk

Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the coronavirus 2 that causes severe acute respiratory syndrome (SARS-CoV-2). More discussion is required to achieve the balance between clinical benefit and risk in the treatment of acute coronary syndrome (ACS) patients with COVID-19. The current COVID-19 pandemic prompts the need to evaluate criteria for indication and efficacy of the general safety protocols and particular cardiac catheterization laboratory (CCL) procedures to safeguard the patient and healthcare professionals

scholarly journals Off-the-shelf barrier for emergency intubation in the cardiac catheterization laboratory during the coronavirus disease 2019 (COVID-19) pandemic

2020 ◽  
Vol 109 (12) ◽  
pp. 1507-1509
Author(s):  
Bruno Scheller ◽  
Davor Vukadinovic ◽  
Sebastian Ewen ◽  
Felix Mahfoud
Keyword(s):  
Acute Coronary Syndrome ◽  
Lead Glass ◽  
Protection Device ◽  
Transparent Plastic ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Coronary Syndrome ◽  
Plastic Bag ◽  
Protective Cover ◽  
Protection Devices

AbstractWith the spread of SARS-CoV-2, it is expected that cases of acute coronary syndrome in the setting of coronavirus disease 2019 (COVID-19) develop. As expensive and sophisticated protection devices are not widely available, we have been working on a simple, off-the-shelf protection device for endotracheal intubation of potentially infected patients. For this purpose, we used a large transparent plastic bag (such as the sterile protective cover of the lead glass shield) for protection from airborne infections. The cover is moved over the patient's head from cranial to caudal, covering the catheter table including the torso with no need for patient mobilization. The intubation is done conventionally under direct visual control.

scholarly journals Prehospital management of patients with suspected acute coronary syndrome

2020 ◽  
Author(s):  
V.-S. Eckle ◽  
S. Lehmann ◽  
B. Drexler
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Catheterization ◽  
Emergency Care ◽  
Care Service ◽  
Prehospital Care ◽  
St Segment Elevation ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Coronary Syndrome ◽  
Prehospital Management

Abstract Background In case of suspected acute coronary syndrome (ACS), international guidelines recommend to obtain a 12-lead ECG as soon as possible after first medical contact, to administrate platelet aggregation inhibitors and antithrombins, and to transfer the patient as quickly as possible to an emergency department. Methods A German emergency care service database was retrospectively analysed from 2014 to 2016. Data were tested for normal distribution and the Mann–Whitney test was used for statistical analysis. Results are presented as medians (IQR). Results A total of 1424 patients with suspected ACS were included in the present analysis. A 12-lead ECG was documented in 96% of patients (n = 1369). The prehospital incidence of ST-segment elevation myocardial infarction (STEMI) was 18% (n = 250). In 981 patients (69%), acetylsalicylic acid (ASA), unfractionated heparin (UFH), or ASA and UFH was given. Time in prehospital care differed significantly between non-STEMI (NSTEMI) ACS (37 [IQR 30, 44] min) and STEMI patients (33 [IQR 26, 40] min, n = 1395, p < 0.0001). Most of NSTEMI ACS and STEMI patients were brought to the emergency care unit, while 30% of STEMI patients were directly handed over to a cardiac catheterization laboratory. Conclusions Prehospital ECG helps to identify patients with STEMI, which occurs in 18% of suspected ACS. Patients without ST-elevations suffered from longer prehospital care times. Thus, it is tempting to speculate that ST-elevations in patients prompt prehospital medical teams to act more efficiently while the absence of ST-elevations even in patients with suspected ACS might cause unintended delays. Moreover, this analysis suggests the need for further efforts to make the cardiac catheterization laboratory the standard hand-over location for all STEMI patients.

Outcome of Patients With Acute Coronary Syndrome Admitted to Hospitals With or Without Onsite Cardiac Catheterization Laboratory

2002 ◽  
Vol 1 (4) ◽  
pp. 232-237 ◽  
Author(s):  
Nasser Lakkis ◽  
Valeri Tsyboulev ◽  
Michael C. Gibson ◽  
Sabina A. Murphy ◽  
William S. Weintraub ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Catheterization ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Coronary Syndrome

scholarly journals Experience of the use of the PCSK9 inhibitor Alirocumab in patients with extremely high cardiovascular risk

Kardiologiia ◽  
2020 ◽  
Vol 60 (8) ◽  
pp. 71-77
Author(s):  
V. A. Korneva ◽  
T. Yu. Kuznetsova ◽  
I. S. Scopetc ◽  
N. N. Vezikova
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiovascular Risk ◽  
Cerebrovascular Disease ◽  
Laboratory Data ◽  
Myocardial Revascularization ◽  
Real Life ◽  
Transient Ischemic Attacks ◽  
High Cardiovascular Risk ◽  
Pcsk9 Inhibitor ◽  
Coronary Syndrome

Aim To study the efficacy and safety of alirocumab in patients with high and very high cardiovascular risk in the Republic of Karelia and to evaluate their compliance with the alirocumab therapy.Materials and methods Study design: observational, noncomparative. The observation group consisted of 9 patients receiving alirocumab (Praluent®) (mean age, 48.6±4.7 years; 7 men). 7 patients had familial hypercholesterolemia of the type diagnosed by DLCN criteria; five patients had MI. Lipid profile, concentrations of transaminases, creatinine, glucose, and lipoprotein a (LP(a)) were measured at 3, 6, 12, and 18 months. Electrocardiography was performed, and the clinical picture (development of acute coronary syndrome, acute cerebrovascular disease, transient ischemic attacks, myocardial revascularization, and cardiovascular death) was evaluated. Efficacy criteria included the absence of these clinical conditions, the proportion of patients who achieved the LDL CS goal, and the decrease in LP(a). Safety was evaluated by clinical and laboratory data, such as levels of transaminases, total bilirubin, creatinine, and blood glucose. The observation lasted for 6 months to 1.5 years.Results LDL CS goals were achieved in 7 (77.8%) patients receiving alirocumab. The mean level of LP(a) decreased from 0.39 to 0.28 g/l; the degree of decrease ranged from 20 to 33 %. No cases of IHD instability (acute coronary syndrome) or new cases of acute cerebrovascular disease and transient ischemic attacks were observed. None of the patients had to stop the alirocumab treatment; adverse effects, including local ones, were not observed.Conclusion LDL CS goals were achieved in 7 (77.8%) patients. The level of LP(a) decreased by 20-33% in patients receiving the PCSK9 inhibitor. In real-life clinical practice, the alirocumab treatment was characterized with high compliance and good tolerability without side effects, including local ones.

The Reduction of Cardiac Patients in the Coronary Care Unit of the Santa Izabel Hospital During the COVID-19 Pandemic

2021 ◽  
Vol 4 (3/4) ◽  
pp. 131-134
Author(s):  
Gilson Feitosa ◽  
Leandro Cavalcanti ◽  
Amanda Fraga ◽  
Milana Prado ◽  
Gilson Feitosa Filho ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Coronary Care Unit ◽  
Myocardial Revascularization ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
The World ◽  
St Elevation ◽  
Coronary Care

The coronary care unit by Santa Izabel Hospital (Salvador, Bahia, Brazil) made a comparison of admitted patients with coronary disease cases admitted between two equivalent periods ranging from April through July in 2019 and 2020. There was a striking reduction in 2020 of cases of ST-elevation myocardial infarction (39%); non-ST elevation myocardial infarction (19%); and unstable angina pectoris (21%). This occurred in parallel with what happened in many parts of the world and hampered offering the best treatment strategy to these patients with an acute coronary syndrome such as invasive stratification and myocardial revascularization.  

scholarly journals Implementation of an Acute Coronary Syndrome Simulation Training Strategy for Emergency Healthcare Professionals

2018 ◽  
Author(s):  
Maíra Viana Rego Souza-Silva ◽  
Priscilla Fortes de Oliveira Passos ◽  
Thais Ribeiro Lemos ◽  
Bárbara Campos Abreu Marino ◽  
Thatiane Dantas Dias ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Simulation Training ◽  
Healthcare Professionals ◽  
Training Strategy ◽  
Coronary Syndrome

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 774 Young adults with acute coronary syndrome: still a long road ahead

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Jessica Ielapi ◽  
Salvatore De Rosa ◽  
Giuseppe Deietti ◽  
Claudia Critelli ◽  
Giuseppe Panuccio ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Young Adults ◽  
Myocardial Revascularization ◽  
Young Patients ◽  
Clinical Profile ◽  
University Hospital ◽  
Complete Revascularization ◽  
Percutaneous Coronary Angioplasty ◽  
Coronary Syndrome ◽  
Magna Graecia

Abstract Aims Acute coronary syndrome (ACS) are a leading cause for mortality and morbility worldwide. Despite ACS usually affects the older population, it also occurs in younger individuals. Young ACS patients (YACS) have a significantly worse prognosis compared to their age-mates in the general population. Despite YACS are characterized by a different risk profiles compared to their older mates, many aspects still remain elusive. Aim of this study was to describe the clinical profile of young adults with Acute Coronary Syndrome. Methods and results Young patients (≤50 years) with the first diagnose of Acute Coronary Syndrome admitted to the Magna Graecia University Hospital were enrolled in the ongoing GENEPAMY registry. Over 7 years, a total of 675 eligible patients with Acute Coronary Syndrome aged 44 ± 8 years were included. Men accounted for 84.9% of all patients. Overall, 11.9% of patients had diabetes, 69.1% hypertension, 17.6% obesity, 93.6% dyslipidemia, while 75.5% were smokers. In the overall cohort, 44.1% were first diagnosed with STEMI, 45.9% with NSTEMI, while the remaining had been admitted for Unstable Angina. Cardiogenic shock was present at admission in 2.7% of cases. Multivessel disease was present in 39% of cases and was significantly less frequent in women (P &lt; 0.001). Thrombolysis was administered as the initial treatment in 15.1% of cases but was ineffective in 66.7% of patients. Percutaneous coronary angioplasty was performed in 79.1% of patients, while 1.9% of patients underwent surgical myocardial revascularization. Spontaneous coronary dissection was present in 0.7% of men and 17.2% of women (P &lt; 0.001). At admission, 98.9% of patients had been treated with ASA, 17.9% with clopidogrel, 49.1% with ticagrelor and 28.4% with prasugrel. A complete revascularization was achieved in 81.6% during the index hospitalization but was significantly more frequent in women compared to men (86.3% vs. 80.8; P &lt; 0.001). Conclusions Our data highlight that YACS present a peculiar clinical profile. In particular, the high cardiovascular risk profile demands attention. Finally, despite most patients were men, young women with ACS present several relevant differences compared to men, needing a more careful clinical management.

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