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

Anti-Platelet and Anti-Thrombotic Therapy Post-AMI

2011 ◽  
Author(s):  
Dana Dawson ◽  
Keith Fox
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Myocardial Reperfusion ◽  
St Elevation Myocardial Infarction ◽  
Coagulation Cascade ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation

• Acute coronary syndromes (ACS) encompass a spectrum of presentations which include unstable angina, non-ST-elevation myocardial infarction (NSTEMI or NSTE-ACS), and ST-elevation myocardial infarction (STEMI or STE-ACS)• Anti-platelet and anti-thrombotic agents are administered as ancillary therapy to myocardial reperfusion in patients presenting with an acute coronary syndrome, to maintain the patency of the infarct-related coronary artery• More specific and potent inhibitors of platelet activation and of the coagulation cascade are emerging with the aim being to further improve clinical outcomes in patients presenting with an acute coronary syndrome, without increasing the risks of major bleeding.

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 The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS): Design and Methodology

2021 ◽  
Vol 11 (2) ◽  
pp. 84-97
Author(s):  
Malcolm. E. Legget ◽  
Vicky. A. Cameron ◽  
Katrina. K. Poppe ◽  
Sara Aish ◽  
Nikki Earle ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
New Zealand ◽  
Acute Coronary Syndromes ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Prospective Longitudinal ◽  
First Time

Background. Each year, approximately 5000 New Zealanders are admitted to hospital with first-time acute coronary syndrome (ACS). The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) is a prospective longitudinal cohort study embedded within the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry in six hospitals. The objective of MENZACS is to examine the relationship between clinical, genomic, and cardiometabolic markers in relation to presentation and outcomes post-ACS. Methods. Patients with first-time ACS are enrolled and study-specific research data is collected alongside the ANZACS-QI registry. The research blood samples are stored for future genetic/biomarker assays. Dietary information is collected with a food frequency questionnaire and information about physical activity, smoking, and stress is also collected via questionnaire. Detailed family history, ancestry, and ethnicity data are recorded on all participants. Results. During the period between 2015 and 2019, there were 2015 patients enrolled. The mean age was 61 years, with 60% of patients aged <65 years and 21% were female. Ethnicity and cardiovascular (CV) risk factor distribution was similar to ANZACS-QI: 13% Māori, 5% Pacific, 5% Indian, and 74% NZ European. In terms of CV risk factors, 56% were ex-/current smokers, 42% had hypertension, and 19% had diabetes. ACS subtype was ST elevation myocardial infarction (STEMI) in 41%, non-ST elevation myocardial infarction (NSTEM) in 54%, and unstable angina in 5%. Ninety-nine percent of MENZACS participants underwent coronary angiography and 90% had revascularization; there were high rates of prescription of secondary prevention medications upon discharge from hospital. Conclusion. MENZACS represents a cohort with optimal contemporary management and will be a significant epidemiological bioresource for the study of environmental and genetic factors contributing to ACS in New Zealand’s multi-ethnic environment. The study will utilise clinical, nutritional, lifestyle, genomic, and biomarker analyses to explore factors influencing the progression of coronary disease and develop risk prediction models for health outcomes.

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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