scholarly journals PLATELET DISTRIBUTION WIDTH VALUE AS A DIAGNOSTIC AND PROGNOSTIC MARKER IN ACUTE CORONARY SYNDROME

Author(s):  
Rahmi Rifany Latif ◽  
Liong Boy Kurniawan ◽  
Darmawati Rauf

An acute coronary syndrome is a form of clinical manifestation of coronary heart disease with atherosclerosis, and thrombosis processes. Platelets play an essential role in thrombosis. High PDW shows a variation of the morphology, and size of a platelet. This was a retrospective cross-sectional study comparing PDW, length of stay, and patient outcome in STEMI, NSTEMI, UAP, and control patients at the Dr.Wahidin Sudirohusodo Hospital Makassar during the period of January 2014 – December 2015. Data were analyzed using statistical software. One hundred, and seventy-two ACS patients were included; 65 patients had UAP, 48 patients had STEMI and 59 patients had NSTEMI. Sixty normal patients were included as a control. Kruskal-Wallis test showed a statistical difference in PDW between patients with STEMI, NSTEMI, UAP, and control (p=0.000). Post hoc test showed a significant difference between ACS, and control, STEMI, and control (p=0.000), NSTEMI and control (p=0.000), UAP, and control (p=0.000), but there no significant difference     between STEMI, and NSTEMI (p=0.320), STEMI, and UAP (p=0.980), NSTEMI and UAP (p=0.435). There was no significant difference in PDW between patients who survived, and died (p=0.298), and also patients with a length of stay of ≤ 7 days, and > 7 days (p=0.293). Platelet distribution width was higher in ACS patients compared with control patients, but could not be used to predict the outcome, and length of stay of patients with ACS. It is advisable to do further research with a large sample size to avoid bias.

2014 ◽  
Vol 9 (1) ◽  
pp. 3-8
Author(s):  
Silpi Pervin ◽  
Md Saiful Islam ◽  
Sheuly Ferdoushi ◽  
Mosharaf Hossain ◽  
Tuhin Sultana ◽  
...  

Objective: This cross sectional study was conducted in the dept. of clinical pathology in collaboration with dept. of cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Bangladesh Institute of Research & Rehabilitation of Diabetes Endocrine and Metabolic Disorders (BIRDEM) to evaluate the role of platelet distribution width (PDW) in diagnosing acute coronary syndrome (ACS). Patients & Methods: A total of 142 patients were selected for the study. Of them 79 were cases (patients with acute coronary syndrome) and 63 were controls (patients with non cardiac chest pain). The cardiologist established the diagnosis by clinical examination, ECG and biochemical markers especially troponin I. A structured questionnaire was used which addressed all the variables of interest. Blood samples of the selected patients were taken to investigate their platelet distribution width level and to find its association with ACS. The blood samples was taken properly and processed in a Haematology auto analyzer within 2 hours of collection, which again rechecked manually by peripheral blood film. Statistical analyses were done using mean± standard deviation (SD), t-test, Chi-square (x2) with 95% confidence interval. Test of validity done by receiver operative characteristic curves.Result: In the present study, platelet counts were 273.1±50.15 x 109/L in patients with ACS and 290.78±74.86 x 109/L in control subjects. Platelet counts were slightly low in patients with ACS compared to control subjects. There were no statistical significant differences between the groups in unpaired t- tests. MPV was 12.48±1.17 fl and 10.45±0.66 fl in patients with ACS and control subjects. PDW was 16.23±2.56 fl and 11.89±1.42 fl in patients with ACS and control subjects. Both MPV and PDW were statistically significant between the groups (P<0.001) in unpaired t-test. Patients with acute coronary syndrome the sensitivity, specificity, positive predictive value and negative predictive value of platelet counts, MPV and PDW were obtained by ROC curve and compared with control subjects. The best cut off value of platelet count, MPV & PDW were >225 x 109/L, > 10.7 fl and >12.7 fl respectively. The sensitivity, specificity, accuracy, positive and negative predictive value of platelet counts, MPV and PDW were 83%, 28.1%, 42.3%, 37.6%, 64%; 90.6%, 49.4%, 64.8%, 51.6%, 89.8%; and 94.3%,52.8%, 69%,54.9%, 94.1% respectively. In our study, we found that PDW had higher sensitivity and specificity in contrast to MPV. These PDW are used as predictor for early detection of ACS and risk stratification when other cardiac biomarkers are negative.Conclusion: The PDW is an early indicator to diagnose ACS and correlates with the prognosis of ACS. DOI: http://dx.doi.org/10.3329/uhj.v9i1.19430 University Heart Journal Vol. 9, No. 1, January 2013; 3-8


Author(s):  
Endah Indriastuti ◽  
Yetti Hernaningsih ◽  
Yulia Nadar Indrasari ◽  
Andrianto Andrianto

Acute Coronary Syndrome (ACS) includes ST-Elevation Myocardial Infarction (STEMI), non-ST Elevation MyocardialInfarction (NSTEMI), and Unstable Angina (UA). Platelet plays an essential role in ACS pathogenesis. Immature PlateletFraction (IPF) and platelet indices can predict platelet activations. Platelet indices consist of platelet count, Mean PlateletVolume (MPV), Platelet Distribution Width (PDW), plateletcrit (Pct). This study aimed to analyze the differences of IPF andplatelet indices among ACS patients. This study was an observational analytical cross-sectional study conducted inDr. Soetomo Hospital during May-September 2019. The subjects consisted of 30-STEMI, 25-NSTEMI, and 24-UA patients.The EDTA-samples were measured for platelet indices and IPF using Sysmex XN-1000. The differences between IPF andplatelet indices among STEMI, NSTEMI, and UA patients were analyzed using Kruskal-Wallis and Mann-Whitney test. The IPFvalues were significantly higher in STEMI patients than NSTEMI and UA patients. The IPF values of NSTEMI patients werehigher than UA patients. The MPV, PDW, and P-LCR were significantly higher in STEMI and NSTEMI compared to UA. TheMPV, PDW, and P-LCR values of NSTEMI patients were significantly higher than UA patients. The significant differencesbetween STEMI and NSTEMI toward UA might be caused by the more severe thrombotic conditions in myocardial infarctionpatients than UA. The IPF values were significantly different among each type of ACS patients gave an opportunity using thisparameter to differentiate the ACS types. The MPV, PDW, and P-LCR were significantly higher in myocardial infarctionpatients than UA patients, which also allowed them to use those parameters to differentiate both conditions.


Author(s):  
Elisabetta Colciago ◽  
Simona Fumagalli ◽  
Elena Ciarmoli ◽  
Laura Antolini ◽  
Antonella Nespoli ◽  
...  

Abstract Purpose Delayed cord clamping for at least 60 s is recommended to improve neonatal outcomes. The aim of this study is to evaluate whether there are differences in cord BGA between samples collected after double clamping the cord or without clamping the cord, when blood collection occurs within 60 s from birth in both groups. Methods A cross-sectional study was carried out, collecting data from 6884 high-risk women who were divided into two groups based on the method of cord sampling (clamped vs unclamped). Results There were significant decrease in pH and BE values into unclamped group compared with the clamped group. This difference remained significant when considering pathological blood gas analysis parameters, with a higher percentage of pathological pH or BE values in the unclamped group. Conclusion Samples from the unclamped cord alter the acid–base parameters compared to collection from the clamped cord; however, this difference does not appear to be of clinical relevance. Findings could be due to the large sample size, which allowed to achieve a high power and to investigate very small numerical changes between groups, leading to a statistically significant difference in pH and BE between samples even when we could not appreciate any clinical relevant difference of pH or BE between groups. When blood gas analysis is indicated, the priority should be given to the timing of blood collection to allow reliable results, to assess newborns status at birth and intervene when needed.


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.


2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Pratik Gahalaut ◽  
Nitin Mishra ◽  
Sandhya Chauhan ◽  
Mir Mubashir Ali ◽  
Madhur Kant Rastogi ◽  
...  

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection.


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.


2020 ◽  
Vol 5 (3) ◽  
pp. 57-63
Author(s):  
Tuge Temesgen ◽  

Aim The study was conducted to determine the prevalence of hydatidosis, to identify the association between expected risk factors and occurrence of the disease, to investigate economic importance and to evaluate fertility and viability of the hydatid cyst in cattle slaughtered at the abattoir. Materials and Methods A cross-sectional study, which involves both ante-mortem and post-mortem examination, was conducted at Nekemte municipal abattoir from November 2015 to March 2016. Results A total of 355 local cattle breed was randomly sampled and examined for the presence of hydatid cysts in the organs of the animals using the standard meat inspection procedures, 66 (18.6%) animals were found harboring hydatid cysts. Statistical analysis showed that there was a significant difference (p<0.05) between the prevalence of bovine hydatidosis in all risk factors with exception of sex of the animals. Among 207 hydatid cysts recorded, 93 (44.92%) were from lungs, 65 (31.40%) from livers, 4 (1.93%) from heart, 3 (1.44%) from kidney, 1 (0.48%) from spleen and 41 (19.8%) were in two organs from lung and liver. Fifty-seven (57) of these 207 cysts were randomly selected and subjected to fertility and viability test which revealed 19 (33.33%) as fertile, 25 (43.86 %) sterile and 13 (22.81%) calcified. Viability test proved 7 (12.28%) of 19 fertile cysts as viable and 12 (21.05%) of 19 fertile cysts as non-viable. Viability of cysts in different organs revealed that 5 (16.1%) and 2 (10%) of cysts from lungs and liver, respectively. The estimated financial loss during the study period both due to condemnation of organs and an in direct carcass weight loss from hydatidosis was 2,190,143.52 ETB. Conclusion The results of this study revealed that bovine hydatidosis was an economically important disease of cattle which need serious attention for prevention and control actions in and around Nekemte. Hence, establishment of well-equipped standardized abattoirs, prohibition of backyard slaughter, creation of public awareness, deworming and control of stray dogs are of paramount importance.


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.


2020 ◽  
Vol 37 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Loes T Wouters ◽  
Dorien L Zwart ◽  
Daphne C Erkelens ◽  
Noël S Cheung ◽  
Esther de Groot ◽  
...  

Abstract Background During telephone triage, it is difficult to assign adequate urgency to patients with chest discomfort. Considering the time of calling could be helpful. Objective To assess the risk of acute coronary syndrome (ACS) in certain time periods and whether sex influences this risk. Methods Cross-sectional study of 1655 recordings of telephone conversations of patients who called the out-of-hours services primary care (OHS-PC) for chest discomfort. Call time, patient characteristics, symptoms, medical history and urgency allocation of the triage conversations were collected. The final diagnosis of each call was retrieved at the patient’s general practice. Absolute numbers of patients with and without ACS were plotted and risks per hour were calculated. The risk ratio of ACS at night (0 to 9 am) was calculated by comparing to the risk at other hours and was adjusted for gender and age. Results The mean age of callers was 58.9 (standard deviation ±19.5) years, 55.5% were women and, in total, 199 (12.0%) had an ACS. The crude risk ratio for an ACS at night was 1.80 (confidence interval 1.39–2.34, P &lt; 0.001): 2.33 (1.68–3.22, P &lt; 0.001) for men and 1.29 (0.83–1.99, P = 0.256) for women. The adjusted risk ratio for ACS of all people at night was 1.82 (1.07–3.10, P = 0.039). Conclusions Patients calling the OHS-PC for chest discomfort between 0 and 9 am have almost twice a higher risk of ACS than those calling other hours, a phenomenon more evident in men than in women. At night, dispatching ambulances more ‘straightaway’ could be considered for these patients with chest discomfort. Trial number NTR7331.


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