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

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

2019 ◽  
Vol 81 (3) ◽  
Author(s):  
Nurliyana Juhan ◽  
Zarina Mohd Khalid ◽  
Yong Zulina Zubairi ◽  
Ahmad Syadi Mahmood Zuhdi ◽  
Wan Azman Wan Ahmad

Cardiovascular disease is the leading cause of death in Malaysia and globally. This study aimed to identify associated risk factors in cardiovascular disease among ST elevation myocardial infarction (STEMI) male patients and obtain a feasible model to describe the data. A total of 16,673 STEMI male patients from 18 participating hospitals across Malaysia in the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013 were analysed. Univariate analysis was conducted. Significant variables from the univariate analysis were further analysed by a multivariate logistic analysis to identify the prognostic factors. The most prevalent risk factor for male patients was smoking (79.3%), followed by hypertension (54.9%) and diabetes mellitus (40.4%). At univariate level, this study is consistent with the findings from the Malaysian National Health and Morbidity Survey (NHMS) where smoking is a significant risk factor. After adjustment in multivariate logistic model, the risk factors for cardiovascular death among male patients are related to age, premorbid condition such as diabetes mellitus, hypertension, family history of CVD, Killip class, type of treatment such as percutaneous coronary intervention (PCI) and relevant comorbidity such as renal disease. Drastic efforts in the management of all risk factors in males is needed to improve adherence outcomes.


2017 ◽  
Vol 5 (2) ◽  
pp. 106-109
Author(s):  
Md Zahid Alam ◽  
Aparna Rahman ◽  
Shabnam Jahan Hoque ◽  
SM Rezaul Irfan ◽  
Md Babul Miah ◽  
...  

Background: Dyslipidemia is one of the main risk factors with prognostic significance in relation to coronary heart disease. Aggressive treatment has been recommended in acute coronary syndrome (ACS). We examined pattern of dyslipidemia in ST Elevation myocardial infarction (STEMI) and Non- ST elevation myocardial infarction (NSTEMI). We also compare the lipid status in between two types of myocardial infarction (MI).Methods: This cross sectional observational study was carried out enrolling 100 subjects with ST elevation and Non ST elevation Myocardial Infarction, in the Department of Cardiology, BIRDEM General Hospital, Shahbag, Dhaka, over a period of six months from January 2012 to June 2012. Fasting lipid profile was done in next morning of admission in both type of MI.Results: Mean age and gender difference was significant between STEMI and NSTEMI. Mean Cholesterol (chol), Triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were not statistically significant between male and female groups. All mean cholesterol, TG, HDL, LDL were significantly high in older age group. The Mean cholesterol (220.7±28.1Vs208.4±20.9), triglyceride (182.8±34.4 Vs 147.4±28.9), HDL (35.14±5.7 Vs 41.65±3.8) and LDL (160.7±26.2 Vs148.3±16.8)were also statistically significant between STEMI and NSTEMI groups (p<0.05).Conclusion: Dyslipidemia is the dominating coronary risk factors. It could be concluded that significant differences are observed between two types of MI. Lipid status is relatively more uncontrolled in ST elevated MI and must be managed with all possible therapeutic modules to minimize further complications.Bangladesh Crit Care J September 2017; 5(2): 106-109


2013 ◽  
Vol 52 (190) ◽  
Author(s):  
Mani Prasad Gautam ◽  
Guruprasad Sogunuru ◽  
Gangapatnam Subramanyam ◽  
Lekhjung Thapa ◽  
Raju Paudel ◽  
...  

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.


2019 ◽  
Vol 16 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Abhishesh Shakya ◽  
Sunil Chandra Jha ◽  
Ratna Mani Gajurel ◽  
Chandra Mani Poudel ◽  
Ravi Sahi ◽  
...  

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.


Author(s):  
Mirna Rahmafindari ◽  
Leonita Anniwati ◽  
Muh. Aminuddin ◽  
Ferdy R. Marpaung

Vitamin D deficiency is associated with cardiovascular disease, one of, which is an Acute Coronary Syndrome (ACS). Some studies provide varying results, the 25 (OH)D levels, which can cause acute coronary syndrome is still controversial. This was an observational analytical study with a cross-sectional design. Samples were collected during April-September 2019 from the Dr. Soetomo Hospital, Surabaya. Patients with the acute coronary syndrome (70 persons) consisted of ST-Elevation Myocardial Infarction (STEMI), non-ST-Elevation Myocardial Infarction (NSTEMI), Unstable Angina (UA) were measured for 25 (OH)D and the differences in levels of 25 (OH)D between groups. Examination of 25 (OH)D used a competitive antibody method chemiluminescence immunoassay. There were different levels of 25 (OH)D patients with ACS versus healthy persons, p=0.0001. There was no difference in levels of 25 (OH)D in UA patients versus healthy persons, p=0.925. Acute coronary syndrome patients had higher 25 (OH)D levels than healthy persons, so it seemed that vitamin D did not play an essential role in the occurrence of ACS based on this study. This study showed that there were significant differences between 25 (OH)D levels in STEMI and healthy persons, NSTEMI and healthy persons, STEMI and NSTEMI, STEMI and UA, NSTEMI and UA. In the UA group and healthy persons, no statistically significant differences were found.


2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Willy Valerian ◽  
Masrul Syafri ◽  
Zelly Dia Rofinda

AbstrakSindrom Koroner Akut (SKA) merupakan spektrum dari penyakit arteri koroner yang tidak stabil, mulai dari angina pektoris tidak stabil sampai infark miokardium. SKA terbagi atas Unstable Angina Pectoris (UAP), ST elevation myocardial infarction (STEMI), Non-ST elevation myocardial infarction (NSTEMI). Tujuan penelitian ini adalah untuk menentukan hubungan antara kadar gula darah saat masuk rumah sakit dan jenis SKA. Metode penelitian yang digunakan adalah cross sectional. Penelitian dilakukan di Instalasi Rekam Medik RS Dr. M. Djamil Padang dengan mengambil data pasien SKA dari Januari 2012 sampai Desember 2012. Hasil penelitian ini didapatkan jenis SKA dengan gula darah yang tidak normal dari 60 sampel, yaitu: UAP 25%, NSTEMI 35%, STEMI 40%. Hasil pengolahan data dapat dilihat bahwa nilai p = 0,592 yang artinya tidak terdapat hubungan yang bermakna antara kadar gula darah saat masuk rumah sakit dengan jenis SKA. Hal ini terjadi mungkin karena terlalu sedikitnya sampel dan banyak sampel kriteria ekslusi dalam pencarian data. Sebaiknya dalam penelitian yang akan datang dapat memperbanyak sampel.Kata kunci: sindrom koroner akut, kadar gula darah, hubungan kadar gula darah dengan SKA AbstractAcute Coronary Syndrome (ACS) is a spectrum of coronary artery disease that is not stable, ranging from unstable angina to myocardial infarction. Acute Coronary Syndrome is divided into Unstable Angina Pectoris (UAP), ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI). The objective of this study was to determine the relationship between blood sugar levels when admitted to hospital and Acute Coronary Syndrome type by using cross sectional study. The study was conducted at the Medical Records RS Dr. M. Djamil Padang. The ACS data collected from January 2012 until December 2012. The results of this study was found the SKA with abnormal blood sugar of 60 samples, i.e. UAP25%, NSTEMI35%, 40% STEMI. On the results of data processing can be seen that the value of p=0.592, which means there is no significant correlation between blood sugar levels upon hospital admission and the type of SKA. No relationship because of little samples and exclusion criteria. The further study has to used more samples.Keywords: acute coronary syndrome, blood sugar levels, blood sugar relationship 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 ◽  
...  

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.


2021 ◽  
Vol 8 (41) ◽  
pp. 3553-3558
Author(s):  
Uday Subhash Bande ◽  
Kalinga Bommanakatte Eranaik ◽  
Manjunath Shivalingappa Hiremani ◽  
Basawantrao Kailash Patil ◽  
Sushma Shankaragouda Biradar

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).


2021 ◽  
Vol 4 (3/4) ◽  
pp. 131-134
Author(s):  
Gilson Feitosa ◽  
Leandro Cavalcanti ◽  
Amanda Fraga ◽  
Milana Prado ◽  
Gilson Feitosa Filho ◽  
...  

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.  


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