COVID-19 and Acute Coronary Syndromes: Current Data and Future Implications

Coronavirus disease-2019 (COVID-19) pandemic is a global healthcare burden, characterized by high mortality and morbidity rates all over the world. During the outbreak period, the topic of acute coronary syndromes (ACS) has raised several clinical issues, due to the risks of COVID-19 induced myocardial injury and to the uncertainties about the management of these cardiologic emergency conditions, which should be organized optimizing the diagnostic and therapeutic resources and ensuring the maximum protection to healthcare personnel and hospital environment. COVID-19 status should be assessed as soon as possible. Moreover, considerably lower rates of hospitalization for ACS have been reported all over the world, due to patients' hesitations to refer to hospital and to missed diagnosis. As a result, short- and long-term complications of myocardial infarction are expected in the near future; therefore, great efforts of healthcare providers will be required to limit the effects of this issue. In the present review we discuss the impact of COVID-19 pandemic on ACS diagnosis and management, with possible incoming consequences, providing an overview of the available evidence and suggesting future changes in social and clinical approach to ACS.

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Non-specific pain and 30-day readmission in acute coronary syndromes: findings from the TRACE-CORE prospective cohort

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02195-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jinying Chen ◽

Catarina I. Kiefe ◽

Marc Gagnier ◽

Darleen Lessard ◽

David McManus ◽

...

Keyword(s):

Chest Pain ◽

Language Processing ◽

Prospective Cohort ◽

Acute Coronary Syndromes ◽

Healthcare Providers ◽

Moderate Pain ◽

Post Discharge ◽

Patient Reported ◽

Coronary Syndromes ◽

The Impact

Abstract Background Patients with acute coronary syndromes often experience non-specific (generic) pain after hospital discharge. However, evidence about the association between post-discharge non-specific pain and rehospitalization remains limited. Methods We analyzed data from the Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) prospective cohort. TRACE-CORE followed patients with acute coronary syndromes for 24 months post-discharge from the index hospitalization, collected patient-reported generic pain (using SF-36) and chest pain (using the Seattle Angina Questionnaire) and rehospitalization events. We assessed the association between generic pain and 30-day rehospitalization using multivariable logistic regression (N = 787). We also examined the associations among patient-reported pain, pain documentation identified by natural language processing (NLP) from electronic health record (EHR) notes, and the outcome. Results Patients were 62 years old (SD = 11.4), with 5.1% Black or Hispanic individuals and 29.9% women. Within 30 days post-discharge, 87 (11.1%) patients were re-hospitalized. Patient-reported mild-to-moderate pain, without EHR documentation, was associated with 30-day rehospitalization (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.14–3.62, reference: no pain) after adjusting for baseline characteristics; while patient-reported mild-to-moderate pain with EHR documentation (presumably addressed) was not (OR: 1.23, 95% CI: 0.52–2.90). Severe pain was also associated with 30-day rehospitalization (OR: 3.16, 95% CI: 1.32–7.54), even after further adjusting for chest pain (OR: 2.59, 95% CI: 1.06–6.35). Conclusions Patient-reported post-discharge generic pain was positively associated with 30-day rehospitalization. Future studies should further disentangle the impact of cardiac and non-cardiac pain on rehospitalization and develop strategies to support the timely management of post-discharge pain by healthcare providers.

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A Report on COVID-19 Variants, COVID-19 Vaccines and the Impact of the Variants on the Efficacy of the Vaccines

Journal of Clinical and Medical Research ◽

10.37191/mapsci-2582-4333-3(3)-066 ◽

2021 ◽

Author(s):

Michael Halim

Keyword(s):

South Africa ◽

Immune Response ◽

Clinical Characteristics ◽

Systemic Review ◽

Review Of Literature ◽

Negative Effects ◽

Mortality And Morbidity ◽

The World ◽

Different Strains ◽

The Impact

The Coronavirus pandemic has caused negative effects across the globe; mortality and morbidity being the main impact. After WHO, termed the disease a pandemic in March 2020, they gave in health guidelines to follow to control the spread of the disease. The health industry, academia, and different governments are united to develop and test various vaccines at an unprecedented speed to combat the pandemic fully and bring the world back to its feet. Some of the vaccines developed include Pfizer, Moderna, and AstraZeneca. However, just like other viruses, the SAR-CoV-2 virus keeps changing through mutation, as various variants, different from the first one are emerging. Evidence shows that the three new variants; UK, Brazil, and South Africa are more severe in terms of transmissibility, disease severity, evading of the immune response, and reducing the ability to neutralized antibodies, compared to the original coronavirus. With such knowledge of the existence of different strains, the arises concerns on whether the already available vaccines are effective enough in preventing the new COVID-19 strains. Studies are still underdeveloped to learn more on the virologic, epidemiologic, and clinical characteristics of the ever-emerging variants. This research, through a systemic review of literature, seeks to find out whether the variants of SAR-CoV-2 have an impact on the efficacy of various vaccines developed in fighting the disease and the entire body’s immune response.

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Coronavirus Pandemic: Coping with the Psychological Outcomes, Mental Changes, and the “New Normal” During and After COVID-19

10.36811/ojda.2020.110005 ◽

2020 ◽

pp. 07-19

Author(s):

Hiba Takieddine ◽

Samaa AL Tabbah

Keyword(s):

Healthcare Providers ◽

Well Being ◽

World Health ◽

Vulnerable Groups ◽

Public Health Response ◽

New Normal ◽

The World ◽

Health Organization ◽

The Impact

Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has rapidly swept across the world, inducing a considerable degree of fear, worry and concern in the population at large and among certain groups in particular, such as older adults, healthcare providers and people with underlying health conditions. Authorities around the world tried to prevent the virus spread by imposing social distancing measures, quarantining citizens and isolating infected persons. Apart from its physical impact, COVID-19 pandemic has brought numerous changes to people’s lives. It changed daily routines, caused worldwide economic crisis, increased unemployment, and placed people under emotional and financial pressures. It affected people psychologically and mentally especially in terms of emotions and cognition. During the acute crisis, everyone to varying degrees experienced fear of infection, somatic concerns, worries about the pandemic’s consequences, loneliness, depression, stress, as well as increased alcohol and drug use. As part of its public health response, the World Health Organization (WHO) has worked with partners to develop a set of new guidelines and messages that can be used to prevent, manage, and support mental and psychological well-being in different vulnerable target groups during the outbreak. Whether people like it or not, the psychological sequela of this pandemic will emerge and persist for months and years to come leading to long-term consequences. New lifestyles and “New Normals” will surely emerge. The main purpose of this review is to summarize the impact of coronavirus pandemic on the psychological and mental health of people around the world especially vulnerable groups. It also presents the relevant intervention actions and recommendations to cope efficiently and effectively with the psychological short-term and long-term outcomes, mental changes, and the “New Normal” during and after COVID-19. Keywords: COVID-19; Coronavirus, Psychological; Mental; New Normal

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Association of fibrinogen and D‑dimer levels with severity of acute coronary syndromes

Journal of Rare Cardiovascular Diseases ◽

10.20418/jrcd.v0i0.409.g327 ◽

2020 ◽

Author(s):

Mukhyaprana M. Prabhu ◽

Jagadish Madireddy ◽

Ranjan K. Shetty ◽

Weena Stanley

Keyword(s):

Acute Coronary Syndromes ◽

Pearson Correlation ◽

Characteristic Curve ◽

Left Ventricular ◽

Mortality And Morbidity ◽

Lv Dysfunction ◽

Coronary Syndromes ◽

The Mean ◽

A Prospective Study ◽

D Dimer

Background: Acute coronary syndromes (ACSs) are the primary cause of mortality worldwide. The aim of the study was to assess the as‑sociations of serum fibrinogen and plasma D‑dimer levels with angiographic severity of atherosclerotic lesions as well as the presence of in‑hospital complications and complications at 30‑day follow‑up in patients with ACS. Methods: This was a prospective study including 107 patients with ACS. Severity of CAD was assessed by the Gensini score. Correlations of D‑dimer and fibrinogen levels with complica‑tions such as heart failure, arrhythmia, recurrent angina, and cardiac death were assessed using the Pearson correlation coefficient and the receiver operating characteristic curve analysis. Results: The mean age of patients was 61±10.9 years. Mean serum fibrinogen levels were higher in individuals with severe left ventricular (LV) dysfunction than in those with moderate and mild LV dysfunction (444 mg/dl, 404 mg/dl, and 330 mg/dl, respectively). Similarly, the mean plasma D‑dimer level was higher in individuals with severe ACS (1.03 μg/ml) than in those with moderate (1.88 μg/ml) and mild ACS (3.5 μg/ml). Conclusion: Our study revealed that patients with higher serum fibrinogen levels tend to have more severe ACS, greater LV dysfunction, and a higher rate of complications. Therapies aimed at reducing fibrinogen levels might help reduce mortality and morbidity in patients with ACS.

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Chinese Herb and Formulas for Promoting Blood Circulation and Removing Blood Stasis and Antiplatelet Therapies

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/184503 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 22

Author(s):

Yue Liu ◽

Hui-Jun Yin ◽

Da-zhuo Shi ◽

Ke-ji Chen

Keyword(s):

Acute Coronary Syndromes ◽

Blood Circulation ◽

Adverse Reactions ◽

Chinese Herb ◽

Blood Stasis ◽

Bleeding Risk ◽

Blood Stasis Syndrome ◽

The World ◽

Close Relationship ◽

Coronary Syndromes

Atherothrombosis, which directly threatens people's health and lives, is the main cause of morbidity and mortality all over the world. Platelets play a key role in the development of acute coronary syndromes (ACSs) and contribute to cardiovascular events. Oral antiplatelet drugs are a milestone in the therapy of cardiovascular atherothrombotic diseases. In recent years, many reports have shown the possibility that “resistance” to oral anti-platelet drugs and many adverse reactions, such as serious bleeding risk, which provides an impetus for developing new anti-platelet drugs possesses highly efficiency and fewer adverse effects. Study on the blood stasis syndrome and promoting blood circulation and removing blood stasis is the most active field of research of integration of traditional and western medicine in China. Blood-stasis syndrome and platelet activation have close relationship, many Chinese herb and formulas for promoting blood circulation and removing blood stasis possess definite anti-platelet effect. This paper covers the progress of anti-platelet mechanism of Chinese herb and formulas for promoting blood circulation and removing blood stasis and is to be deeply discussed in further research.

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