scholarly journals Fragmented QRS Complex as a Predictor of Multivessel Disease in Acute Coronary Syndrome

2017 ◽  
pp. 130-6
Author(s):  
Idar Mappangara ◽  
Abdul Hakim Alkatiri ◽  
Stefan Hendyanto

Background: The incidence of multivessel disease in acute coronary syndrome (ACS) is expected to be identified as early as possible in order to perform optimal management. The presence of multivessel disease can lead to ischemia or myocardial infarction. Fragmented QRS complex (fQRS) is a new electrocardiography (ECG) parameter that has been proven to be caused by ischemia or myocardial infarction.Methods: A cross-sectional study. Patients with ACS that admitted at Dr. Wahidin Sudirohusodo Makassar since December 2014 - March 2015 who are eligible were enrolled in this study.Presence of fQRS evaluated on first 12-lead ECG at hospital admission. Presence of multivessel disease based on coronary angiography. Data were analyzed by logistic regression. Data was significant if the p-value<0.05.Results: There are 63 subjects (56 men and 7 women) included in this study. Older age, history of ACS before, presence of dyslipidemia, and presence of fQRS were significantly more often in group with multivessel disease. After analyzed with logistic regression, the fQRS was the only significant predictor of multivessel disease with p value 0.003 and odds ratio 13.28.Conclusion: Presence of fQRS in the first 12-lead ECG when admitted to the hospital was an independent predictor of multivessel disease in patients with ACS.

2017 ◽  
Vol 24 (03) ◽  
pp. 409-413
Author(s):  
Naveed Aslam Lashari ◽  
Nadia Irum Lakho ◽  
Sarfaraz Ahmed Memon ◽  
Ayaz Ahmed ◽  
Muhammad Fahad Waseem

Introduction: ACS is defined as the cluster of symptoms arising due to the rapiddrop of blood flow to the heart because of coronary artery obstruction. It is stated that worldwidearound 17 million people die due to cardiovascular diseases of which half of the deaths arereported due to ACS. Chest pain is known to be the most leading factor associated with ACS.Objectives: To determine the frequency of acute coronary syndrome, its types and commoncontributing factors in patients presenting with typical chest pain in a secondary care hospital.Study Design: Cross sectional study. Setting: Medical Unit, PAF Hospital Mushaf Sargodha.Period: October 2013 to March 2014. Methodology: A total of 280 patients of either gender,aged 20 to 80 years presented with typical chest pain with or without conventional risk factorswere included in the study. Results: Majority (68.9%) was males and 31.1% were female. Acutecoronary syndrome was observed in 131(46.8%) patients. Out of these 131 patients, 55% hadNSTEMI, 28.2% had unstable angina and 16.8% had STEMI. A higher proportion of femaleswere found to have ACS as compared to males (75.9% vs 33.7%, P-value<0.0001). Out of131 patients, 40.5% were diabetic, 29.8% were hypertensive 16% were hyperlipidemic, while13.7% were smokers. Conventional risk factors except smoking were observed more in femalesas compared to males. Conclusion: Majority of patients with acute coronary syndrome werefemales and diabetic. NSTEMI was the most common type of ACS. Prevalence of conventionalrisk factors was found more in females with ACS.


2021 ◽  
Vol 28 (01) ◽  
pp. 60-65
Author(s):  
Muhammad Yasir ◽  
Muhammad Usman ◽  
Munir Ahmed ◽  
Rehan Riaz ◽  
M Hamid Saeed

Objective: To determine the frequency of fragmented QRS complex in patients with acute non-ST elevation myocardial infarction (NSTEMI). Study Design: Cross-Sectional Study. Setting: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad. Period: July 15, 2019 to January 15, 2020. Material & Methods: One hundred and forty five diagnosed patients of NSTEMI on the basis of chest pain and positive troponin-I were included in this study. The electrocardiography (ECG) was performed to document the presence or absence of f QRS complex in these patients. A 12-lead ECG with paper speed of 25 or 50 mm per second and a voltage of 10 mm/mv was used. FQRS was labeled (as per operational definition). The collected data were entered and analyzed statistically by using SPSS v25.0. Data were stratified for age, gender, diabetes, smoking and hypertension. Post-stratification, f QRS complex was compared by Chi-Square test in stratified groups. A p-value ≤0.05 was taken as significant. Results: Total 145 patients presenting with NSTEMI were selected for this study. Mean age of the patients was 48.2±12.3 year. Among these patients, 90(62.1%) were males, while 55(37.9%) were females. Overall frequency of fQRS complex in patients with NSTEMI was 64(44.1%). Conclusion: There is an association of fQRS among patients with acute non-ST elevation myocardial infarction (NSTEMI). Further prospective studies are needed to determine the clinical significance of fQRS complex and identify its correlation with the incidence of possible complications.


2021 ◽  
Vol 29 (01) ◽  
pp. 82-87
Author(s):  
Syeda Sabahat Haider ◽  
Muhammad Shahid ◽  
Khalid Razaq ◽  
Shama Iqbal ◽  
Muhammad Tariq Ghafoor ◽  
...  

Objective: To determine the frequency of hypercholesterolemia in patients who are diagnosed with acute coronary syndrome and to also document the association of Non HDL-C with Acute coronary syndrome in these patients. Study Design: Observational Cross Sectional study. Setting: Department of Cardiology and Pathology of Sheikh Zayed Hospital, Rahim Yar Khan. Period: September 2019 to February 2020. Material & Methods: One hundred and thirty five patients with Acute coronary syndrome were included using non probability purposive sampling technique and equal number of patient who visited the outpatient department or admitted in indoor with complaints other than ACS were taken as control (n=135). Frequency and percentages were calculated and odd ratio was determined to see the association. Statistical significance was set at P-value<0.05. Results: Patient’s mean age was 55.5±12.4 years and there were 98(73%) male and 37(27%) female. Higher Non HDL-C (>130mg/dl) was found in 120(88.9%) cases and in 38(28.1%) controls with odd ratio 20.4211 at 95 %CI and p value <0.001.Hypercholesterolemiawas seen in 49(36.3%) of the cases while in 21(15.6%) of control group (without ACS) with odd ratio of 3.3 and p-value <0.001. Odds ratio was maximum for Non HDL cholesterol, followed by LDL cholesterol, HDL cholesterol and Total cholesterol. Conclusion: Non-HDL cholesterol showed a good association in patients with ACS than with primary target LDL-C or total cholesterol.


2020 ◽  
Vol 16 (1) ◽  
pp. 28-32
Author(s):  
Md Abu Raihan Ferdous ◽  
Mrm Mandal ◽  
Faisal Ibn Kabir ◽  
Md Rasul Amin ◽  
Syed Ali Ahsan ◽  
...  

Fragmented QRS (f-QRS) complex in 12 lead ECG may develop in the background of acute coronary syndrome (ACS). This study was aimed to evaluate the angiographic severity of CAD among non-ST ACS patients having f-QRS in the ECG.This cross-sectional observational study was conducted in Cardiology department of BSMMU. Total 52 non-ST ACS patients who underwent invasive coronary angiography (CAG) were included in two groups according to presence or absence of f-QRS complex. 25 patients were included in f-QRS group and 27 in non-f-QRS group. After CAG, severity of CAD was assessed and compared by number of vessel involvement and degree of vessel stenosis. Patients’ demographic parameters were same in both groups. Depending on the number of vessel involvement, it was found that among f-QRS patient group, highest percentage had triple vessel (32%) followed by double vessel (28%) and single vessel (24%) disease and 16% patient had normal or non-critical epicardial coronary arteries. Among non-f QRS group, highest percentage had normal or non-critical lesions (40.7%) followed by double vessel (25.9%), single vessel (22.2%) and triple vessel disease (7.4%). In conclusion, this study revealed that presence of f-QRS in ECG is associated with more severe form of CAD and once the finding is observed, the particular patient should be targeted for aggressive management. University Heart Journal Vol. 16, No. 1, Jan 2020; 28-32


2019 ◽  
Vol 16 (2) ◽  
pp. 63-67
Author(s):  
Navaraj Paudel ◽  
Abhishek Maskey ◽  
Dipesh Karki ◽  
Sushant Katwal ◽  
Namrata Thapa

Background and Aims: Microalbuminuria (MA) (urinary albumin excretion of 30-299 mg/d in a 24 hours collection or 30-299 μg/mg creatinine in a spot collection) is well accepted marker of micro and macrovascular damage in patients with diabetes mellitus and is considered as a surrogate marker for endothelial dysfunction in diabetic and non-diabetic patients. This study has been undertaken to investigate the prevalence of microalbuminuria among non-diabetic Acute Coronary Syndrome (ACS) patients. Methods: A hospital based cross-sectional study of 100 consecutive non-diabetic ACS patients was done. Traditional risk factors (like smoking, hypertension, dyslipidemia, obesity) of coronary artery disease were studied for the association with microalbuminuria in study subjects. Investigations were carried out in all the cases as per proforma and entered in the SPSS software for analysis. Results: The prevalence of microalbuminuria in non-diabetic ACS patients in the study was 73% which was statistically significant (p=0.04). A statistically significant higher prevalence of microalbuminuria was seen with different presentations of ACS; being highest (81.96%) in NSTEMI followed by STEMI (63.15%) and Unstable Angina (55%). It was found to be significant with the history of smoking (81.25%, p=0.013) and hypertension (82.25%, p=0.013). No significant association was found with age, body mass index (BMI) and dyslipidemia. A statistically significant higher prevalence of microalbuminuria was seen with increasing number of risk factors. Conclusion: There is increased prevalence of microalbuminuria in ACS patents. MA was associated with statistically higher number of cases with history of smoking and hypertension and presence of increasing number of risk factors.


2020 ◽  
Vol 17 (1) ◽  
pp. 82-93
Author(s):  
Mary-Joe Youssef ◽  
Antoine Aoun ◽  
Aline Issa ◽  
Lana El-Osta ◽  
Nada El-Osta ◽  
...  

Background: The prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide and the related chronic symptoms can be associated with morbidity and poor quality of life. Objective: The objective of this study was to identify foods and beverages consumed by the Lebanese population, dietary habits, socio-demographic and lifestyle factors, health parameters and perceived stress, implicated in increasing GERD symptoms. Methods: This observational cross-sectional study was carried among Lebanese adults in 2016. A convenient sample of 264 participants was equally divided into a GERD group and a control group. Data on socio-demographic characteristics, lifestyle, health status and dietary habits including Lebanese traditional dishes were collected. The perceived stress scale (PSS) was also used to assess the participants’ perception of stress. Logistic regression analyses were conducted with GERD symptoms (presence or absence) being the dependent variable. Results: The GERD symptoms were significantly associated with age (-p-value=0.017), family history of GERD symptoms (-p-value<0.001), smoking (-p-value=0.003) and chronic medical conditions (-p-value<.001). Regarding the dietary factors, participants who ate three meals or less/day, between meals and outside homes were 2.5, 2.9 and 2.4 times at a higher risk of experiencing GERD symptoms than others, respectively. Moreover, the logistic regression model showed that the GERD symptoms were significantly associated with the consumption of coffee (-p-value=0.037), Lebanese sweets (-p-value=0.027), fried foods (-p-value=0.031), ‘Labneh’ with garlic (-p-value<0.001), pomegranate molasses (-p-value=0.011), and tomatoes (-p-value=0.007). Conclusion: Some specific lifestyle factors and components of the Lebanese Mediterranean diet could be associated with GERD symptoms.


2021 ◽  
Vol 10 (11) ◽  
pp. 2475
Author(s):  
Olivier Peyrony ◽  
Danaé Gamelon ◽  
Romain Brune ◽  
Anthony Chauvin ◽  
Daniel Aiham Ghazali ◽  
...  

Background: We aimed to describe red blood cell (RBC) transfusions in the emergency department (ED) with a particular focus on the hemoglobin (Hb) level thresholds that are used in this setting. Methods: This was a cross-sectional study of 12 EDs including all adult patients that received RBC transfusion in January and February 2018. Descriptive statistics were reported. Logistic regression was performed to assess variables that were independently associated with a pre-transfusion Hb level ≥ 8 g/dL. Results: During the study period, 529 patients received RBC transfusion. The median age was 74 (59–85) years. The patients had a history of cancer or hematological disease in 185 (35.2%) cases. Acute bleeding was observed in the ED for 242 (44.7%) patients, among which 145 (59.9%) were gastrointestinal. Anemia was chronic in 191 (40.2%) cases, mostly due to vitamin or iron deficiency or to malignancy with transfusion support. Pre-transfusion Hb level was 6.9 (6.0–7.8) g/dL. The transfusion motive was not notified in the medical chart in 206 (38.9%) cases. In the multivariable logistic regression, variables that were associated with a higher pre-transfusion Hb level (≥8 g/dL) were a history of coronary artery disease (OR: 2.09; 95% CI: 1.29–3.41), the presence of acute bleeding (OR: 2.44; 95% CI: 1.53–3.94), and older age (OR: 1.02/year; 95% CI: 1.01–1.04). Conclusion: RBC transfusion in the ED was an everyday concern and involved patients with heterogeneous medical situations and severity. Pre-transfusion Hb level was rather restrictive. Almost half of transfusions were provided because of acute bleeding which was associated with a higher Hb threshold.


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.


2021 ◽  
Author(s):  
Daba Abdissa ◽  
Workitu Sileshi

Abstract BackgroundSexual and reproductive health (SRH) is at the base of young people's living and wellbeing. A significant number of young peoples are affected by avoidable SRH problems due to a lack of appropriate knowledge regarding SRH. Parent-young communication on SRH is critical in informing them about risk and protective behaviors which in turn decrease the likelihood of involvement in risky sexual behaviors. Therefore, the purpose of this study was to evaluate the parent-young communication on SRH issues among secondary and preparatory school students at Agaro town, Southwestern Ethiopia. MethodsSchool based cross-sectional study was conducted from April 13 to April 20, 2019 using stratified random sampling technique. Data were collected using pretested interviewer-administered structured questionnaire entered into Epi data version 3.1; and analyzed using SPSS version 20. A variable having a p-value of <0.25 in the bivariable logistic regression model was subjected to multivariable logistic regression analysis to avoid the confounding variable’s effect. Adjusted odds ratios were calculated at the 95% confidence interval and considered significant with a p-value of <0.05.ResultsA total of 315 students were included to the study. The mean age of the respondents was 20.2±2.6 years. The study finding showed that 61.3% of the participants were discussed on SRH issues with their parents. Educational status of mother [primary education (AOR=3.67; 95%CI=1.93,6.97),secondary education(AOR:2.86;95%CI=1.20,6.80)],educational status of father[primary education (AOR=5.8;95%CI=2.8,12.3,secondary education (AOR=3.21; 95%CI=1.55,6.59)],having family size of <5 (AOR= 6.4; 95%CI= 3.36,12.37) and having boy/girlfriend(AOR=1.99; 95%CI=1.0,3.8) were significantly associated with parent-young people communication. ConclusionAbout two third of the participants communicate with their parents about SRH issues. Parents’ educational status, family size of <5 and having boy/girlfriend were significantly associated with the parent-young people communication. The main reasons for not communicated was cultural taboos, shame and parents lack of knowledge. Therefore, it is necessary to educate and equip students and parents to address the identified problems.


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.


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