scholarly journals PROFIL HEMATOLOGI PADA SINDROM KORONER AKUT

e-CliniC ◽  
2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Albertus Benedictus Sirait

Abstract: One of cardiovascular disease is syndrome coronary acute. Syndrome coronary acute divided into three groups, they are unstable angina pectoris (UAP), non-ST segment elevation myocardial infarction (NSTEMI), ST segment elevation myocardial infarction (STEMI). Besides the changes of cardiac biomarkers profile, the patient's hematologic profile will also experience changes. This study's aim to determine hematologic profile of syndrome coronary acute and included the profiles of hemoglobin, leukocyte, thrombocyte, hemaocrit, MCV, MCH, and MCHC. The method of this study was analytic with cross-sectional approach and using secondary data, medical report. The samples were all patients that take hospitalization care in BLU RSUP Prof. Dr. R. D. Kandou Manado and diagnosed with syndrome coronary acute in January 2012 to December 2012. The result showed more patient likely to have lower hemoglobin, normal leukocyte, normal thrombocyte, lower hematocrit, normal MCV, MCH, and MCHC. Conclusion: There were changes on hematologic profile even though leukocyte and thrombocye profile more likely found normal. The changes of hematologic profile can be used as basic prognosis for the patients in the future. Keywords: Profile hematology, syndrome coronary acute.     Abstrak: Salah satu penyakit kardiovaskuler adalah sindrom koroner akut. Sindrom koroner akut dibagi menjadi tiga kelompok yaitu angina pektoris tidak stabil (UAP), infark miokard tanpa elevasi segmen ST (NSTEMI), dan infark miokard dengan elevasi segmen ST (STEMI). Selain terjadinya perubahan pada biomarker cedera jantung, profil hematologi pasien juga akan mengalami perubahan. Penelitian ini bertujuan untuk mengetahui profil hematologi pada sindrom koroner akut dan meliputi profil hemoglobin, leukosit, trombosit, hematokrit, MCV, MCH, dan MCHC. Penelitian ini menggunakan metode analitik dengan pendekatan cross-sectional dengan menggunakan data sekunder berupa rekam medis. Sampel dalam penelitian ini adalah semua pasien di BLU RSUP Prof. Dr. R. D. Kandou Manado yang dirawat inap dengan diagnosis sindrom koroner akut pada periode Januari 2012 sampai dengan Desember 2012. Hasil penelitian menunjukkan pasien cenderung lebih banyak pasien yang memiliki profil hemoglobin yang rendah, nilai leukosit yang normal, nilai trombosit normal, nilai hematokrit yang rendah, nilai MCV, MCH, dan MCHC yang normal. Kesimpulan: Terdapat perubahan pada profil hematologi meskipun pada profil leukosit dan trombosit cenderung lebih banyak pasien yang memiliki profil yang normal. Perubahan nilai profil hematologi pada pasien bisa dijadikan dasar prognosis bagi pasien kedepannya. Kata kunci: profil hematologi, sindrom koroner akut.

2013 ◽  
Author(s):  
R Scott Wright ◽  
Joseph G Murphy

Patients with coronary artery disease (CAD) present clinically when their disease enters an unstable phase known as an acute coronary syndrome (ACS), in which the cap of a previously stable atheromatous coronary plaque ruptures or erodes, which in turn activates a thrombotic cascade that may lead to coronary artery occlusion, myocardial infarction (MI), cardiogenic shock, and patient death. There are nearly 2 million episodes of ACS in the United States annually; it is the most common reason for hospitalization with CAD and is the leading cause of death in the developed world. ACS patients include those with unstable angina (UA), non–ST segment elevation myocardial infarction (non-STEMI), and ST segment elevation myocardial infarction (STEMI) and patients who die suddenly of an arrhythmia precipitated by coronary occlusion. The distinction among various ACS subgroups reflects varying characteristics of clinical presentation (presence or absence of elevated cardiac biomarkers) and the type of electrocardiographic (ECG) changes manifested on the initial ECG at the time of hospitalization. This chapter focuses on UA and non-STEMI. A graph outlines mortality risks faced by patients with varying degrees of renal insufficiency. An algorithm describes the suggested management of patients admitted with UA or non-STEMI. Tables describe the risk stratification of the patient with chest pain, categories of Killip class, examination findings of a patient with high-risk ACS, diagnosis of MI, causes of troponin elevation other than ischemic heart disease, initial risk stratification of ACS patients, and long-term medical therapies and goals in ACS patients. This review contains 2 highly rendered figures, 11 tables, and 76 references.


2021 ◽  
Vol 18 (3) ◽  
pp. 51-56
Author(s):  
Mădălina Badea ◽  
Ana-Maria Balahura ◽  
Daniela Bartoş

Abstract According to tradition, every year, at the Congress of the European Society of Cardiology new clinical guidelines, usefull for our daily pratice, are launched. This year a new guideline for the management of non-ST-segment elevation myocardial infarction (NSTEMI) was presented. Substantial resources had been invested to sustain the research efforts in order to improve the diagnosis and therapeutic tools for this disease. In this article we present the main differences between this guideline and the previous one, regarding the utility of the cardiac biomarkers, diagnosis and risk stratification algorithms, and last, but not least, medical and invasive treatment tools.


2013 ◽  
Vol 7 (3) ◽  
pp. 230-235 ◽  
Author(s):  
Hesham R Omar ◽  
James Fairbairn ◽  
Hany D Abdelmalak ◽  
Maja Delibasic ◽  
Enrico M Camporesi

Takotsubo cardiomyopathy is an increasingly recognized clinical disorder mimicking acute coronary syndrome. It is usually preceded by physical or emotional stress and recovery of the left ventricular systolic function occurs in most cases within 1–4 weeks. Takotsubo cardiomypathy can masquerade as ST-segment elevation myocardial infarction when chest pain, ST-segment elevation, and high cardiac biomarkers coexist. ST-segment elevation is encountered in approximately half of the cases of takotsubo cardiomyopathy and its pattern is indistinguishable at times from ST-segment elevation myocardial infarction. However, several electrocardiographic criteria have been shown to characterize takotsubo cardiomyopathy. Awareness of these electrocardiographic features has several diagnostic and therapeutic implications. Nevertheless, these electrocardiographic criteria alone cannot reliably differentiate between both entities, and the diagnosis of takotsubo cardiomyopathy is only established after coronary angiography confirms the absence of occlusive coronary artery disease and the characteristic apical ballooning is evident on left ventriculogram (in the case of the apical form). Herein, we present a case of postoperative takotsubo cardiomyopathy and discuss the various electrocardiographic features that raise suspicion for this transient cardiac syndrome.


Author(s):  
Yong Zhu ◽  
Chengping Hu ◽  
Yu Du ◽  
Yan Liu ◽  
Jinxing Liu ◽  
...  

Abstract Background Resistin, a proinflammatory adipocytokine secreted predominately by macrophages in humans, plays an important role in the pathogenesis and development of atherosclerosis. The present research mainly investigated the association between serum resistin level and peak hypersensitive cardiac troponin I (hs-cTnI) in patients with ST-segment elevation myocardial infarction (STEMI).Methods We consecutively enrolled 92 patients with a first STEMI in this cross-sectional and observational study. Resistin concentrations upon admission and 24 h and 72 h after primary percutaneous coronary intervention (PCI) were all measured. The change in resistin (δ Resistin) was defined as (serum resistin concentration at admission)-(serum resistin concentration 24 h after intervention).Results Serum resistin concentration decreased rapidly after primary PCI. Resistin at admission correlated positively with tumour necrosis factor-α (r = 0.522, p<0.001) and macrophage migration inhibitory factor (r = 0.471, p<0.001). Additionally, resistin at admission correlated negatively with the reactive oxygen species scavengers superoxide dismutase (r = -0.261, p = 0.012) and glutathione peroxidase (r = -0.235, p = 0.024). Most importantly, serum resistin concentrations upon admission (r = 0.381, p<0.001) and 24 h (r = 0.372, p<0.001) and 72 h (r = 0.347, p = 0.001) after primary PCI all correlated with peak hs-cTnI, while δ Resistin was not associated with peak hs-cTnI. After multiple linear regression analysis, serum resistin (beta = 13.593, 95% CI 5.951 to 21.235, p < 0.001) at admission and 24 h (beta = 13.972, 95% CI 5.662 to 22.282, p = 0.001) and 72 h (beta = 14.455, 95% CI 5.178 to 23.733, p = 0.003) after intervention remained associated with peak hs-cTnI.Conclusions In our present research, serum resistin concentrations at different time points all correlated positively with peak hs-cTnI, which may suggest that serum resistin concentrations during the acute phase of STEMI are useful for forecasting myocardial infarction size and prognosis in patients after primary PCI. Additionally, our research also indicated that resistin may regulate myocardial IRI partly by promoting the inflammatory process and oxidative stress.


2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Valeria Cammalleri ◽  
Saverio Muscoli ◽  
Daniela Benedetto ◽  
Giuseppe Stifano ◽  
Massimiliano Macrini ◽  
...  

Background After the coronavirus disease 2019 outbreak, social isolation measures were introduced to contain infection. Although there is currently a slowing down of the infection, a reduction of hospitalizations, especially for myocardial infarction, was observed. The aim of our study is to evaluate the impact of the infectious disease on ST‐segment–elevation myocardial infarction (STEMI) care during the coronavirus disease 2019 pandemic, through the analysis of recent cases of patients who underwent percutaneous coronary intervention. Methods and Results Consecutive patients affected by STEMI from March 1 to 31, 2020, during social restrictions of Italian government, were collected and compared with patients with STEMI treated during March 2019. During March 2020, we observed a 63% reduction of patients with STEMI who were admitted to our catheterization laboratory, when compared with the same period of 2019 (13 versus 35 patients). Changes in all time components of STEMI care were notably observed, particularly for longer median time in symptom‐to‐first medical contact, spoke‐to‐hub, and the cumulative symptom‐to‐wire delay. Procedural data and in‐hospital outcomes were similar between the 2 groups, whereas the length of hospitalization was longer in patients of 2020. In this group, we also observed higher levels of cardiac biomarkers and a worse left ventricular ejection fraction at baseline and discharge. Conclusions The coronavirus disease 2019 outbreak induced a reduction of hospital access for STEMI with an increase in treatment delay, longer hospitalization, higher levels of cardiac biomarkers, and worse left ventricular function.


Author(s):  
Nahid Salehi ◽  
Reza Heidari Moghadam ◽  
Alireza Rai ◽  
Nafiseh Montazeri ◽  
Javad Azimivghar ◽  
...  

Introduction: Acute myocardial infarction (AMI) is a leading cause of death and disability worldwide. Determining seasonal pattern of AMI may contribute to disease prevention and better treatment. Objective: The present study was conducted to investigate daily, monthly, and seasonal pattern for symptoms҆ onset in the patients with ST-segment elevation myocardial infarction (STEMI), and also other possible associated factors. Methods: This cross-sectional study was conducted on 777 patients diagnosed with STEMI admitted at the Imam Ali Cardiovascular Hospital affiliated with Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran from March 2018 to February 2019. Data were collected using a checklist developed based on the study's objectives. Differences between subgroups were assessed using one-way analysis of variance (ANOVA) followed by Tukeys҆ post‐hoc test and Chi-Square test (or Fishers҆ exact test). Results: Out of 777 patients, 616 (79.3%) of them were male. Mean age of the patients was (mean±SD) equal to 60.93±12.86 years old. Occurrence of STEMI was most common in winter (38.4%), followed by autumn (27.8%), spring (22.9%), and summer (10.9%), respectively. Monthly occurrence of AMI was at the highest level in January (10.8%) and December (9.9%), and it was at the lowest level in July (4.9 %). Most patients were admitted on Fridays (15.8%) and Wednesdays (15.6%). Hypercholesterolemia, prior congestive heart failure (CHF), prior MI, prior stroke, prior atrial fibrillation (AF), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, creatine phosphokinase (CPK), and creatine kinase myocardial band (CK-MB) were significantly associated with seasonal pattern of STEMI (p-value<0.05). Conclusions: Results of the present study on Iranian patients with STEMI revealed that AMI occurred more frequently on Wednesdays and Fridays and during winter from December to January compared to the other days of the week, months, and seasons.


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