scholarly journals Acute Coronary Syndrome in an Intensive Care Unit of a Tertiary Referral Centre in Central Nepal: The Spectrum and Coronary Risk Factors.

2013 ◽  
Vol 52 (190) ◽  
Author(s):  
Mani Prasad Gautam ◽  
Guruprasad Sogunuru ◽  
Gangapatnam Subramanyam ◽  
Lekhjung Thapa ◽  
Raju Paudel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Intensive Care Unit ◽  
Coronary Heart Disease ◽  
Acute Coronary Syndrome ◽  
Intensive Care ◽  
Heart Disease ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
St Elevation

Introduction: Acute coronary syndrome is the major leading cause for coronary care unit admission. Its spectrum comprises a variety of disorders including unstable angina, non ST elevation and ST elevation myocardial infarction.Methods: An observational study was designed to study the spectrum of acute coronary syndrome and associated coronary heart disease risk factors in subjects admitted in intensive care unit from August 2009 to September 2010. Details including coronary risk factors and the categories and outcomes of acute coronary syndrome were analyzed.Results: A total of 57 subjects were included in the study. The majority (63.1%) were males. The mean age was 64.54±13.8 years.  Five (8.8%) patients were ≤45 years and 29 (50.88%) patients were ≥65 years. Majority of the patients were smokers (50.87%). The other major coronary heart disease risk factors were diabetes (43.85%), hypertension (36.87%), dyslipidemia (26.32%) and previous history of coronary heart disease (31.58%). Coronary heart disease figured prominently in the family history as well (26.32%). ST elevation myocardial infarction was the major category (42.11%) followed by non-ST elevation myocardial infarction and unstable angina (31.58% and 26.32% respectively). Myocardial infarction complicated with cardiogenic shock had very high mortality (83.33%).  Conclusions: The ST elevation myocardial infarction was the major clinical form of acute coronary syndrome admitted in intensive care unit. Prevention should be targeted on modifiable risk factors such as the management of risk factors. In addition, the improvement in cardiology service with the establishment of CCU and cathlab might alter the mortality and morbidity in ACS management.Keywords: acute coronary syndrome; coronary risk factors; intensive care unit.

scholarly journals Clinical characteristics, risk factors and angiographic profile of acute coronary syndrome patients in a tertiary care center of Nepal.

2019 ◽  
Vol 16 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Abhishesh Shakya ◽  
Sunil Chandra Jha ◽  
Ratna Mani Gajurel ◽  
Chandra Mani Poudel ◽  
Ravi Sahi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
St Elevation ◽  
Artery Disease

Background and Aims: Acute coronary syndrome (ACS) refers to a group of clinical symptoms consistent with new onset or worsening ischemic symptoms. ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA) are the three types of ACS. The objectives were to study the risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in ACS among patients admitted in Cardiology Department of Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC). Methods: This is a restrospective study of 419 ACS patients admitted and treated in MCVTC from November 2017 to October 2018. Patients were divided into STEMI, NSTEMI and UA then analyzed for various risk factors, angiographic patterns and severity of coronary artery disease. Results: Mean age of presentation was 59.3Å}12.8 years. Majority were male 317(75.7%). Most patients had STEMI 252 (60.1%) followed by NSTEMI 98 (23.4%) and UA 69 (16.5 %). Risk factors: smoking was present in 241 (57.5%), hypertension in 212 (50.6%), diabetes in 144 (34.4%), dyslipidemia in 58 (13.8%). Single-vessel disease was present in 34.6 % patients, double- vessel disease was present in 27.44 % patients and triple vessel disease was present in 26.3 % patients, left main disease in 1.4 % patients. Normal coronaries were present in 6.4% patients and minor coronary artery disease in 3.8 % patients. Conclusions: STEMI was the most common presentation. Three quarters of ACS were male patients. Smoking was most prevalent risk factor. Single vessel involvement was the most common CAG finding in all spectrum of ACS. Diabetic patients had more multivessel disease.

scholarly journals Gambaran Derajat Hipertensi Pada Pasien Sindrom Koroner Akut (SKA) di RSUP PROF. R. D. Kandou Manado Periode Januari - Desember 2014

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Agus Mawardy ◽  
Janry A. Pangemanan ◽  
Dewi Utari Djafar
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Life Style ◽  
St Elevation Myocardial Infarction ◽  
Modifiable Risk Factors ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
St Elevation

Abstract : Acute Coronary Syndrome (ACS) is an uncomfortable condition or other symptoms in the chest due to lack of oxygen consumption in myocardium. Risk factors of acute coronary syndrome divided to two are modifiable risk factors and non- modifiable risk factors. Modifiable risk factors like hypertension, cholesterol, smoke, obesity, diabetes mellitus, hyperuricemia, physical inactivity, stress and life style. Non- modifiable risk factors like ages, gender, and family history disease. The purpose of this research is to know degree of hypertension and prevalence of hypertension in patient with acute coronary syndrome on RSUP Prof. R. D. Kandou Manado. This research used the observational descriptive method with cross sectional approach. Total sample of this research are 86 patients. The data have been collected by see patient’s medical record. The result showed 86 patient acute coronary syndrome where total of unstable angina pectoris were 47 patients, total of non ST elevation myocardial infarction were 20 patients, and total of ST elevation myocardial infarction were 19 patients. 60 cases were man and 28 cases were woman. 34 cases were pre-hypertension, 43 cases were hypertension stage 1, and 9 cases were hypertension stage 2. The majority of acute coronary syndrome cases were 56-65 years old.Keywords : acute coronary syndrome, degree of hypertensionAbstrak : Sindrom Koroner Akut (SKA) adalah sebuah kondisi yang melibatkan ketidaknyamanan pada dada atau gejala lain yang disebabkan oleh kurangnya oksigen ke otot jantung (miokardium). Faktor risiko SKA dapat dibagi dua yaitu faktor risiko yang dapat bisa diubah (modifiable), yaitu: hipertensi, kolesterol, merokok, obesitas, diabetes mellitus, hiperurisemia, aktivitas fisik kurang, stress, dan gaya hidup (life style). Faktor risiko yang tidak dapat diperbaiki seperti usia, jenis kelamin, dan riwayat penyakit keluarga. Tujuan penelitian ini untuk mengetahui gambaran derajat hipertensi dan prevalensi hipertensi pada pasien Sindrom Koroner Akut (SKA) di RSUP Prof. Dr. R. D kandou Manado. Penelitian ini merupakan jenis penelitian retrospektif observasional, dengan pendekatan cross sectional. Sampel penelitian sebanyak 86 pasien. Pengambilan data dilakukan dengan melihat catatan rekam medik pasien. Hasil penelitian didapatkan 86 penderita sindrom koroner akut dimana jumlah penderita angina pektoris tidak stabil adalah 47 orang, jumlah penderita infark miokard akut tanpa elevasi segmen ST adalah 20 orang, dan jumlah penderita infark miokard akut dengan elevasi segmen ST adalah 19 orang. Penderita sindrom koroner akut yang berjenis kelamin laki-laki adalah 60 orang, sedangkan perempuan berjumlah 26 orang. Terdapat 34 orang yang termasuk didalam pre-hipertensi, 43 orang dengan Hipertensi derajat 1, dan 9 orang termasuk Hipertensi derjat 2. Kelompok usia terbanyak sindrom koroner akut adalah 56-65 tahun.Kata Kunci : Sindrom Koroner Akut, Derajat Hipertensi

scholarly journals GAMBARAN HEMATOLOGI PADA PASIEN SINDROM KORONER AKUT YANG DIRAWAT DI BLU RSUP PROF. Dr. R.D. KANDOU MANADO TAHUN 2010

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Bagus Yuvi Setyo Ramadhani ◽  
Linda W.A Rotty ◽  
Frans Wantania
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Hematological Parameters ◽  
Secondary Data ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Hematological Changes

Abstract: Acute coronary syndrome (ACS) is a series of clinical disorders caused by acute ischemic heart disease, including angina unstable, non-ST elevation myocardial infarction, and ST-elevation myocardial infarction. This study aimed to determine the relationship of routine hematological changes with the course of acute coronary syndromes. We used a descriptive method. Data were obtained from the secondary data of ACS patients in the ICCU RSUP Prof. Dr. R. D. Kandou Manado during 2010. The data were presented in distributive tables. The results showed that most patients did not experience decreases in hematological parameters such as hemoglobin, hematocrite, erythrocyte counts, and platelet counts. The leucocyte counts increased in 50% of cases. Conclusion: In general, there was no decrease in hematological parameters, except leukocyte counts, among the ACS patients in the ICCU RSUP Prof. Dr. R. D. Kandou Manado during 2010. Keywords: acute coronary syndrome, coronary heart disease, hematology, inflammation Abstrak: Sindrom koroner akut (SKA) merupakan rangkaian gangguan klinis yang disebabkan oleh penyakit akut iskemik jantung, termasuk angina tidak stabil, non-ST elevasi miocard infraction, dan ST-elevasi miocard infraction. Penelitian ini bertujuan untuk mengetahui hubungan perubahan hematologi rutin dengan perjalanan penyakit sindrom koroner akut. Penelitian ini memakai metode deskriptif dengan menggunakan data sekunder dari penderita SKA di ruang ICCU RSUP Prof. Dr. R. D. Kandou Manado selama tahun 2010. Data hasil penelitian disajikan dalam bentuk tabel distributif. Hasil penelitian  memperlihatkan bahwa sebagian besar pasien tidak memperlihatkan penurunan parameter hematologi. Jumlah leukosit meningkat pada 50% kasus. Simpulan: Umumnya tidak terdapat penurunan parameter hematologi, kecuali jumlah leukosit pada pasien SKA ruang ICCU RSUP Prof. Dr. R. D. Kandou Manado selama tahun 2010. Kata kunci: Sindrom koroner akut, penjakit jantung koroner, Hematologi, inflamasi

Optical coherent tomography for the diagnostic of non-obstructive coronary artery myocardial infarction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
I Leonova ◽  
S Boldueva ◽  
V Feoktistova ◽  
D Evdokimov
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Atherosclerotic Plaque ◽  
St Elevation ◽  
Spontaneous Dissection

Abstract Funding Acknowledgements Type of funding sources: None. The widespread use of coronary angiography (CAG) in patients with acute coronary syndrome led to the understanding that in some patients myocardial infarction (MI) occurs against angiographically unchanged or slightly modified coronary arteries (CA). In such cases, the so-called "type 2 IM" is diagnosed in some patients, however, to determine the true cause of MI, a modern method of investigation such as optical coherence tomography (OCT) is needed to visualize the intima of the CA and detect a minimal atherosclerotic process.  The purpose of the study was to establish the etiology of MI without obstructive coronary artery disease (MINOCA) using OCT. Materials and methods 160 conclusions of the OCT were analyzed. In 9 (6%) cases, the study was conducted in patients who underwent proven MI (mean age 43,1 ± 13,2, 8 males, 1 female) who had no hemodynamically significant CA stenosis according to CAG data. Results in 2 cases (22%) patients had ST-elevation MI, thrombotic occlusion of the CA (in one case, thrombaspiration was performed). In both patients, spontaneous dissection of the intima of the unmodified CA was detected in the OCT. The remaining 7 patients had non-ST-elevation MI, and in 2 cases, a diagnosis of type 2 MI was established: in both patients, the atherosclerotic plaque was visualized, narrowing the lumen of the CA less than 50%, in one case MI developed against a background of the hypertensive crisis, in another - against a background of spasm of CA. In the remaining 5 patients, OCT revealed subintimal atheromatous, with elements of local dissection of the intima. Thus, in 78% of patients atherosclerosis of CA of different severity (from the subintimal deposition of lipids to the development of atherosclerotic plaque, narrowing the clearance of the SC by less than 50%) was diagnosed. In the analysis of risk factors for coronary heart disease (CHD), 57% of patients with atheromatous CA had more than 2 risk factors for CHD: 3 (42%) smoked, 5 (71%) - obesity, 4 (57% ) - had arterial hypertension, 3 (42%) had dyslipidemia, 1 (14%) had type 2 diabetes. In the group of patients with spontaneous intima dissection of the CA, 1 patient (woman) did not have CHD risk factors, the 2-nd suffered from obesity and hypertension. For all patients a lifestyle correction was recommended; statins, antiplatelets were prescribed, patients with spontaneous dissection of CA had the recommendation of examination in the medical-genetic center. Conclusion Based on the results of the study, in most cases, the cause of IMBOC development was an atherosclerotic lesion of the coronary arteries, which is not always visualized with standard coronary angiography. Basically, the patients were young and middle-aged. Most patients had different risk factors for coronary heart disease.

scholarly journals Circulating Levels of Dephosphorylated-Uncarboxylated Matrix Gla Protein in Patients with Acute Coronary Syndrome

Molecules ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 1108
Author(s):  
Admira Bilalic ◽  
Tina Ticinovic Kurir ◽  
Marko Kumric ◽  
Josip A. Borovac ◽  
Andrija Matetic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
High Risk ◽  
Hospital Mortality ◽  
Vascular Calcification ◽  
Matrix Gla Protein ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
St Elevation

Vascular calcification contributes to the pathogenesis of coronary artery disease while matrix Gla protein (MGP) was recently identified as a potent inhibitor of vascular calcification. MGP fractions, such as dephosphorylated-uncarboxylated MGP (dp-ucMGP), lack post-translational modifications and are less efficient in vascular calcification inhibition. We sought to compare dp-ucMGP levels between patients with acute coronary syndrome (ACS), stratified by ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) status. Physical examination and clinical data, along with plasma dp-ucMGP levels, were obtained from 90 consecutive ACS patients. We observed that levels of dp-ucMGP were significantly higher in patients with NSTEMI compared to STEMI patients (1063.4 ± 518.6 vs. 742.7 ± 166.6 pmol/L, p < 0.001). NSTEMI status and positive family history of cardiovascular diseases were only independent predictors of the highest tertile of dp-ucMGP levels. Among those with NSTEMI, patients at a high risk of in-hospital mortality (adjudicated by GRACE score) had significantly higher levels of dp-ucMGP compared to non-high-risk patients (1417.8 ± 956.8 vs. 984.6 ± 335.0 pmol/L, p = 0.030). Altogether, our findings suggest that higher dp-ucMGP levels likely reflect higher calcification burden in ACS patients and might aid in the identification of NSTEMI patients at increased risk of in-hospital mortality. Furthermore, observed dp-ucMGP levels might reflect differences in atherosclerotic plaque pathobiology between patients with STEMI and NSTEMI.

The Study of Serum Calcium to Magnesium Ratio in Patients with Acute Coronary Syndrome in a Tertiary Hospital, Hubli, Karnataka

2021 ◽  
Vol 8 (41) ◽  
pp. 3553-3558
Author(s):  
Uday Subhash Bande ◽  
Kalinga Bommanakatte Eranaik ◽  
Manjunath Shivalingappa Hiremani ◽  
Basawantrao Kailash Patil ◽  
Sushma Shankaragouda Biradar
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Roc Analysis ◽  
St Elevation Myocardial Infarction ◽  
P Value ◽  
Operating Characteristics ◽  
Coronary Syndrome ◽  
Function Tests ◽  
Creatine Kinase Mb ◽  
St Elevation

BACKGROUND Cardiovascular diseases are one of the leading causes of morbidity and mortality worldwide. High Ca levels and low Mg levels are associated with increased cardiovascular risk in the general population.1 The balance between Ca and Mg seems to play an important role in homeostasis since Mg is considered as physiologic antagonist of Ca.2 Hence Ca/Mg ratio was considered to study its association with acute coronary syndrome (ACS). METHODS This is a case control study conducted in Karnataka Institute of Medical Sciences, Hubli over a period of 2 years, February 2019 to December 2020. 200 cases and 150 controls were included in the study. The biochemical measurements including complete blood count (CBC), cardiac biomarkers, liver function tests, renal function tests (RFT), serum electrolytes and lipid profile were measured using standard laboratory methods. Student ‘t’ test was used to compare the data. Optimum cut-offs for diagnosis of acute myocardial infarction was calculated using receiver operating characteristics (ROC) analysis. The association among markers was established by calculating Pearson’s correlation. RESULTS Serum Ca/Mg ratio was significantly higher (p value < 0.001) in ACS when compared to control groups. It was also found that Ca/Mg ratio was significantly lower (p value < 0.001) in non-ST elevation myocardial infarction (NSTEMI) when compared to STEMI group. Serum Mg was significantly lower (p value < 0.001) in ACS group when compared to control group. Significant correlation (p value < 0.05) was found between serum Ca/Mg ratio and cardiac markers (CKMB, Troponin-I). ROC analysis of Ca/Mg (4.19) ratios showed optimum cut-offs in diagnosis of AMI. CONCLUSIONS Serum Ca/Mg could be useful adjuvant marker in diagnosis of AMI. The ratio is higher in ST-segment elevation myocardial infarction when compared to non-STsegment myocardial infarction, which could be due to greater decrease in Mg levels when compared Ca in ACS. KEYWORDS ST Elevation Myocardial Infarction (STEMI), Non ST Elevation Myocardial Infarction (NSTEMI), Calcium (Ca), Magnesium (Mg), Acute Coronary Syndrome (ACS), Creatine Kinase-MB (CK-MB).

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.  

Abstract 18710: Added Value of Electrocardiographic Signs and Symptoms to Improve Early Detection of Acute Coronary Syndrome in the Emergency Department

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jessica K Zègre-Hemsey ◽  
Larisa A Burke ◽  
Holli A DeVon
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Signs And Symptoms ◽  
Symptom Distress ◽  
St Elevation Myocardial Infarction ◽  
Specific Symptom ◽  
Arm Pain ◽  
Coronary Syndrome ◽  
Cardiac Symptoms ◽  
St Elevation

Background: Early identification and diagnosis are critical in the management of patients with acute coronary syndrome (ACS) since time-dependent therapies reduce patient mortality and morbidity. Objective: The aims of this study were to describe differences in presenting symptoms by individual ACS diagnoses and determine the prognostic value of both signs (electrocardiographic evidence of ischemia) and symptoms for an ACS diagnosis. Method: Patients > 21 years old, with any ECG ischemic changes (ST-elevation, ST-depression, T-wave inversion), elevated serum troponin, and ACS symptoms presenting to one of five emergency departments (ED) were eligible for the study. Patients completed the ACS Symptom Checklist, a validated 13-item instrument that measures cardiac symptoms (typical and atypical). Pearson Chi-square tests were used for bivariate analyses and logistic regression was used for multivariate modeling. Results: A total of 1,031 patients (mean age 60 + 14, 62% male, 70% White) were enrolled; 450 (43.7%) were diagnosed with ACS. One hundred eleven (11%) had ST-elevation myocardial infarction (STEMI), 236 (23%) had non-ST elevation myocardial infarction (NSTEMI), 103 (10%) had unstable angina (UA), and 581 (56%) were ruled-out for ACS. Patients with STEMI were more likely to report chest pain, diaphoresis, and higher symptom distress (p<0.05) at presentation than those without. Patients with NSTEMI were more likely to report arm pain and patients with UA were more likely to report lightheadedness (p<0.05). The presence of any chest symptoms (OR 2.24; 95% CI 1.27-3.97), higher symptom distress (OR 1.07; 95% CI 1.0-1.15), and a lower number of symptoms (OR 0.92; 95% CI 0.86-0.98) were independent predictors of an ACS diagnosis (p<0.05). The strongest predictor of an ACS diagnosis was the presence of ECG ischemic changes (OR 4.51, 95% CI 3.20-6.36) adjusting for symptoms, age, gender, heart rate, arrhythmia, and troponin levels (p<0.001). Conclusion: ECG signs of ischemia combined with specific symptom characteristics may enhance timely triage and detection of ACS in the ED. Predictive models that incorporate presenting signs and symptoms should be explored for this vulnerable population.

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