scholarly journals The Most Relevant Factors Affecting the Perioperative Death Rate in Patients with Acute Coronary Syndrome and COVID-19, Based on Annual Follow-Up in the ORPKI Registry

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1813
Author(s):  
Karol Kaziród-Wolski ◽  
Janusz Sielski ◽  
Jacek Sidło ◽  
Rafał Januszek ◽  
Zbigniew Siudak
Keyword(s):  
Acute Coronary Syndrome ◽  
Healthcare System ◽  
Sudden Cardiac Arrest ◽  
Vascular Lesions ◽  
Femoral Access ◽  
Factors Affecting ◽  
Catheterization Laboratory ◽  
Coronary Syndrome ◽  
St Elevation

Background: The COVID-19 pandemic is significantly affecting the functioning of the entire healthcare system. The disease itself may be associated with thromboembolic complications. The purpose of this study is to compare patients with acute coronary syndrome (ACS) and patients with ACS who were diagnosed with COVID-19 in terms of their clinical profile, management, treatment complications, and prognosis. Methods: We analyzed 47,940 cases of patients treated for ACS in 2020, including 44,952 patients (93.8%) who were not diagnosed with COVID-19 and 2988 patients (6.2%) who tested positive for COVID-19. Results: Patients with COVID-19 were significantly more likely to experience out-of-hospital sudden cardiac arrest (7.9 vs. 1.1%; p < 0.0001) and be transported directly to a catheterization laboratory (21.3% vs. 8.1%; p < 0.0001). Mortality was significantly higher in this group (0.9% vs. 0.4%; p < 0.0001). The risk of perioperative death was increased by age over 65 years, use of glycoprotein IIb/IIIa inhibitors (GPI IIb/IIIa), femoral access, critical left main stem coronary artery (LMCA) vascular lesions, ST elevation myocardial infarction (STEMI), and no-reflow phenomenon. Conclusions: Despite the pandemic, patients with COVID-19 were treated equally to healthy patients. Efficient organization of the healthcare system allowed the prompt transportation of patients to catheterization laboratories. The study group was characterized by a worse prognosis that was affected by multiple factors.

scholarly journals Clinical Application of Optical Coherence Tomography in Patients with Non-ST-Elevation Acute Coronary Syndrome Combined with Intermediate Lesions

2017 ◽  
Vol 20 (1) ◽  
pp. 032
Author(s):  
Hua Yu ◽  
Likun Ma ◽  
Kefu Feng ◽  
Hongwu Chen ◽  
Hao Hu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Drug Treatment ◽  
Optical Coherence ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome

Objective: This study aimed to evaluate the clinical significance and safety of optical coherence tomography (OCT) in patients with non-ST-elevation acute coronary syndrome (NSTEACS) combined with intermediate lesions.Methods: Sixty-five NSTEACS patients with intermediate lesions confirmed with coronary angiography at our department were included in this study. Among them, 33 patients received only standardized drug treatment (drug group) and the other 32 patients received percutaneous coronary intervention (PCI) according to the OCT examination based on drug treatment (OCT group). Major adverse cardiovascular events (MACEs), revascularization, success rate of OCT examination, related complications, and other patient situations in the two groups during hospitalization and the 12-month follow-up period were compared.Results: No death or stroke occurred in either group during hospitalization and follow-up. In the drug treatment group, six patients experienced frequent angina, and five patients with acute myocardial infarction were rehospitalized and underwent PCI procedures. In the OCT group, although two patients underwent repeat revascularization, no additional acute myocardial infarction events occurred. There was a statistically significant difference between the two groups (P < .01). All patients in the OCT group successfully completed the related vessel examination, and 24 patients underwent PCI procedures because of unstable plaque diagnosed with OCT.Conclusion: OCT-guided PCI is safe and effective for the treatment of patients with NSTEACS combined with intermediate lesions.

scholarly journals Percutaneous vascular closure device of the femoral access site after coronary interventions for acute coronary syndrome -immediate and short term follow-up

2017 ◽  
Vol 5 (3) ◽  
pp. 778 ◽  
Author(s):  
Ashraf Safiya Manzil ◽  
Sidharaj Vala ◽  
Sidharaj Vala
Keyword(s):  
Acute Coronary Syndrome ◽  
Interventional Procedure ◽  
Tertiary Care ◽  
Major Complication ◽  
Coronary Intervention ◽  
Closure Device ◽  
Short Term ◽  
Femoral Access ◽  
Coronary Syndrome

Background: Around 7 million patients undergo percutaneous interventional vascular procedures worldwide annually and this number is expected to escalate further in coming years. The aim of this study was to analyse immediate and short term follow up of patients with acute coronary syndrome (ACS) who had undergone percutaneous coronary intervention (PCI) through femoral route and closure with vascular closure device.Methods: This was non randomised, single centre study and was conducted in a tertiary care institution between January 2013 to June 2014 with 62 ACS patients undergoing femoral access invasive cardiac interventional procedure. Perclose A-T system was used in all patients as closure device. Patients were followed up to 15 days of clinical evaluation.Results: Of 62 ACS patients, 40 (64.5%) were with non-ST elevation myocardial infarction and 22 (35.5%) patients had history of unstable angina. The perclose device achieved closure within 5 to 10 minutes and all patients were kept in hospital stay for 2 to 3 days. There was one major complication of continuous bleeding, one incidence of small pseudo aneurysm, and two incidences of small hematomas with need of blood transfusion.Conclusions: This study demonstrates the ability of arterial closure device to safely and effectively achieve arterial closure in patients undergoing percutaneous intervention for ACS.

scholarly journals The Strategy of Management Patients with non-ST Elevation Acute Coronary Syndrome

Kardiologiia ◽  
2019 ◽  
Vol 59 (9) ◽  
pp. 40-51
Author(s):  
Yu. A. Prilutskaya ◽  
L. I. Dvoretski
Keyword(s):  
Acute Coronary Syndrome ◽  
Treatment Outcomes ◽  
Treatment Strategy ◽  
Management Strategy ◽  
Factors Affecting ◽  
Invasive Strategy ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome ◽  
Coronary Events

The review covers issues of epidemiology, diagnostics, management strategy, and treatment outcomes in patients with non-ST elevation acute coronary syndrome. Numerous factors affecting the choice of an invasive strategy are analyzed as well as its correspondence to existing recommendations of patient’s management. The stratification of risk of development of adverse coronary events, which is a part of the formation of a treatment strategy, is discussed.

scholarly journals Prediction of major adverse cardiac events of patients with acute coronary syndrome by using TIMI risk index

2013 ◽  
Vol 18 (2) ◽  
pp. 52-57 ◽  
Author(s):  
Mohammad Abul Ehsan ◽  
Md Manzoor Mahmood ◽  
Laila Farzana Khan ◽  
Md Abu Salim
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Risk Index ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events ◽  
St Elevation ◽  
Group 1

Patient with acute coronary syndrome (ACS) has considerable variability in outcome and mortality risk. The Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) for unstable angina/non ST elevation myocardial infarction & ST elevation myocardial infarction were a convenient bedside clinical risk score for predicting 30 days mortality at presentation with ACS. This study was done to predict and validate major adverse cardiac events in patients of ACS thus it will help us to quantify risk, observe the prognostic value and to guide appropriate therapy by using TRI. This prospective study was carried out in the department of cardiology, BSMMU, Dhaka from April, 2011 to March, 2012. After considering all ethical issues, data were collected from 279 patients attending at cardiac emergency department with the presentation of ACS. History & physical examinations were done. TIMI risk index were calculated for each patient. The major adverse cardiac events (recurrent myocardial infarction, urgent revascularization, and all-cause mortality) were measured for next 30 days in hospital setting & outpatient department by follow up. After follow-up, Cox univariate and multivariate regression analysis were used to evaluate the influence of potential risk factors on duration of event-free survival, and likelihood ratio tests to assess the outcome. Major adverse events of TIMI risk index group 1, 2, 3, 4 & 5 were 0%, 0%, 3.7%, 12.9% & 19.2% respectively in UA/NSTEMI group. In STEMI group major adverse cardiac events of TIMI risk index group 1, 2, 3, 4 & 5 were 0%, 4.7%, 12.5%, 17.1% & 24.1% respectively. Increasing TRI were associated with increased risk of major adverse cardiac events. These score were a valid tool for risk assessment. DOI: http://dx.doi.org/10.3329/jdnmch.v18i2.16024 J. Dhaka National Med. Coll. Hos. 2012; 18 (02): 52-57

scholarly journals ACEF performed better than other risk scores in non-ST-elevation acute coronary syndrome during long term follow-up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ivica Kristić ◽  
Nikola Crnčević ◽  
Frane Runjić ◽  
Vesna Čapkun ◽  
Ozren Polašek ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Score ◽  
Treatment Strategies ◽  
Risk Scores ◽  
Coronary Syndrome ◽  
Long Term Follow Up ◽  
St Elevation ◽  
All Treatment

Abstract Background Risk stratification of patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) is an important clinical method, but long-term studies on patients subjected to all-treatment strategies are lacking. Therefore, the aim was to compare several established risk scores in the all-treatment NSTE-ACS cohort during long-term follow-up. Methods Consecutive patients (n = 276) with NSTE-ACS undergoing coronary angiography were recruited between September 2012 and May 2015. Six risk scores for all patients were calculated, namely GRACE 2.0, ACEF, SYNTAX, Clinical SYNTAX, SYNTAX II PCI and SYNTAX II CABG. The primary end-point was Major Adverse Cardiovascular Events (MACE) which was a composite of cardiac death, nonfatal myocardial infarction, ischemic stroke or urgent coronary revascularization. Results During a median follow-up of 33 months, 64 MACE outcomes were recorded (23.2%). There was no difference between risk score categories, except in the highest risk group of ACEF and SYNTAX II PCI scores which exhibited significantly more MACE (51.6%, N = 33 and 45.3%, N = 29, P = 0.024, respectively). In the multivariate Cox regression analysis of individual variables, only age and atrial fibrillation were significant predictors for MACE (HR 1.03, 95% CI 1.00–1.05, P = 0.023 and HR 2.02, 95% CI 1.04–3.89, P = 0.037, respectively). Furthermore, multivariate analysis of the risk scores showed significant prediction of MACE only with ACEF score (HR 2.16, 95% CI 1.36–3.44, P = 0.001). The overall performance of GRACE, SYNTAX, Clinical SYNTAX and SYNTAX II CABG was poor with AUC values of 0.596, 0.507, 0.530 and 0.582, respectively, while ACEF and SYNTAX II PCI showed the best absolute AUC values for MACE (0.630 and 0.626, respectively). Conclusions ACEF risk score showed better discrimination than other risk scores in NSTE-ACS patients undergoing all-treatment strategies over long-term follow-up and it could represent a fast and user-friendly tool to stratify NSTE-ACS patients.

Gap between guidelines and management of patients with acute coronary syndrome without persistent ST elevation. Finnish prospective follow-up survey

2003 ◽  
Vol 37 (4) ◽  
pp. 187-192 ◽  
Author(s):  
Saila Vikman ◽  
Juhani Airaksinen K. E. ◽  
Keijo Peuhkurinen ◽  
Ilkka Tierala ◽  
Kirsi Majamaa-Voltti ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Syndrome ◽  
St Elevation
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