scholarly journals Gambaran Intervensi Koroner Perkutan Primer pada Pasien Infark Miokard Akut dengan Elevasi Segmen ST di RSUP Prof Dr. R. D. Kandou Manado Periode Januari –Desember 2017

e-CliniC ◽  
2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Cristina Lolaen ◽  
Starry H. Rampengan ◽  
Janry A. Pangemanan
Keyword(s):  
Risk Factor ◽  
Sampling Technique ◽  
Coronary Intervention ◽  
Stemi Patient ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Consecutive Sampling ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Male Patients

Abstract: Acute coronary syndrome (ACS) is one of the main problems in the cardiovascular field due to its increasing numbers of morbidity and mortality. One of the classifications of ACS is acute myocardial infarction (AMI) with ST segment elevation (STEMI). Intervention that can be done mechanically for AMI with STEMI is primary percutaneous coronary intervention (PPCI). This study was aimed to determine the profile of PPCI in patients with AMI-STEMI at Prof. Dr. R. D. Kandou Hospital Manado from January to December 2017. This was a descriptive observational study with a retrospective approach using medical record data of AMI-STEMI patients. Samples were obtained by using consecutive sampling technique. The results showed that of the total 132 STEMI patient there were 63 samples that fulfilled the criteria. Most patients were male as many as 57 people (90.5%), aged 45-49 years as many as 17 people (27%), BMI 18,5-24,9 (normal) as many as 42 people (66.6%). Of 63 samples, 24 patients had only one risk factor (38.1%), with hypertension as the most common risk factor in 45 people (71.4%). Among patients that underwent PPCI, the PPCI was predominantly performed on the 3-<6 hours after onset as many as 23 people (36.5%). Conclusion: Among patients that underwent PPCI, male patients were much more common than female, and hypertension was the most risk factor of ACS. Most PPCIs were performed on the 3-<6 hours after onset.Keywords: AMI, STEMI, PPCI Abstrak: Sindrom koroner akut (SKA) merupakan salah satu masalah utama kardiovaskular karena menyebabkan tingginya angka morbiditas dan mortalitas. Salah satu klasifikasi dari SKA ialah infark miokard akut dengan elevasi segmen ST (IMA-EST). Tindakan yang dapat dilakukan secara mekanis yaitu intervensi koroner perkutan (IKP) primer. Penelitian ini bertujuan untuk mengetahui gambaran IKP primer pada pasien IMA-EST di RSUP Prof. DR. R.D. Kandou Manado periode Januari-Desember 2017. Jenis penelitian ialah deskriptif observasional dengan pendekatan retrospektif menggunakan data rekam medik pasien IMA-EST. Teknik pengambilan sampel yaitu consecutive sampling. Hasil penelitian memper-lihatkan dari total 132 pasien IMA-EST didapatkan 63 sampel yang memenuhi kriteria. Frekuensi terbanyak pada jenis kelamin laki-laki sebanyak 57 orang (90,5%), kelompok usia 45-49 tahun 17 orang (27%), IMT 18,5-24,9 (normal) 42 orang (66,6%). Dari jumlah 63 sampel, terbanyak memiliki 1 faktor risiko yaitu 24 orang (38,1%), dengan hipertensi sebagai faktor risiko terbanyak pada 45 orang (71,4%). Pada pasien yang menjalani IKP primer terbanyak dilakukan pada awitan gejala 3-<6 jam yaitu 23 orang (36,5%). Simpulan: Pasien berjenis kelamin laki-laki paling banyak menjalani IKP primer, dengan hipertensi merupakan faktor risiko PJK terbanyak dan IKP primer terbanyak dilakukan pada awitan 3-<6 jam.Kata kunci: IMA-EST, IPK primer

scholarly journals Good Practices in the Clinical Management of Patients with Acute Coronary Syndrome: Retrospective Analysis in a Third-Level Hospital in Mexico

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Héctor E. Flores-Salinas ◽  
Fidel Casillas-Muñoz ◽  
Yeminia Valle ◽  
Cesar M. Guzmán-Sánchez ◽  
Jorge Ramon Padilla-Gutiérrez
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Heart Surgery ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Introduction and Objective. In Mexico, there has been an increase in the risk of cardiovascular disease due to rising life expectancy, westernized lifestyle, lack of prevention, and industrialized exposure. This article describes the pharmacological treatment, surgical interventions, and associated clinical complications in patients diagnosed with acute coronary syndrome (ACS) and their impact on in-hospital mortality frequency in a Cardiology Unit in Instituto Mexicano del Seguro Social. Methods. This is a retrospective study including male and female patients aged ≥18 years who were diagnosed with ACS. The collected data included demographic characteristics, risk factors, medications, electrocardiograms, surgical procedures, and in-hospital deaths. Results. There are at least 20% more diagnoses of ST-segment elevation myocardial infarction in this hospital compared to the latest national reports in Mexico. The most common risk factors were type 2 diabetes mellitus, hypertension, smoking, and dyslipidaemia. Diabetic patients with a clinical history of percutaneous coronary intervention had a higher risk of non-ST-segment elevation myocardial infarction than nondiabetics (OR: 2.34; p=0.013), also smoking patients with previous heart surgery than nonsmokers (OR: 7.73; p=0.0007). The average in-hospital mortality was 3.6% for ACS. Conclusions. There is a higher percentage of coronary interventionism and improvement in pharmacological treatment, which is reflected in lower mortality. The substantial burden of T2DM could be related to a higher number of cases of STEMI. Diabetics with precedent percutaneous coronary intervention and smokers with previous heart surgery have an increased risk of subsequent infarction.

scholarly journals Anticoagulant therapy for non-ST-segment elevation acute coronary syndrome in China: A multi-center observational study

2016 ◽  
Vol 4 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Xiao-huan Gong ◽  
Jin-ming Yu ◽  
Yong Mao ◽  
Da-yi Hu
Keyword(s):  
Acute Coronary Syndrome ◽  
Anticoagulant Therapy ◽  
Coronary Intervention ◽  
Efficacy And Safety ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Elevation Acute Coronary Syndrome ◽  
Lower Incidence Rate

Abstract Objective To assess the anticoagulant therapy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in China and to offer the rationale for establishing reasonable strategies to improve the prognosis of NSTE-ACS. Methods A total of 1,502 patients with NSTE-ACS were recruited from 28 third-grade hospitals distributed in 14 provinces and cities in China from December 2009 to December 2011. The strategies for diagnosis and treatment, decided by each hospital respectively, were used for further analysis and comparison of medication, percutaneous coronary intervention (PCI), and end points for efficacy and safety assessment at 9 and 30 days following PCI. Results A lower incidence rate (P < 0.05) was noted for efficacy and safety in patients with unstable angina (UA) than those with non-ST-segment elevation myocardial infarction (NSTE-MI). The prescription rate of unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), fondaparinux, PCI, and single medication was 0.61%, 66.42%, 30.61%, 69.64%, and 70.74%, respectively. Conclusion Compared with NSTE-MI, UA is featured with better prognosis, less severity, and different outcome. However, in clinical practice, the therapies for NSTE-MI and UA show no differences, which deserves great attention. In China, the most common anticoagulant therapies for NSTE-ACS are single medication, mainly based on LMWH and PCI.

Glycoprotein IIb/IIIa Receptor Inhibitors in Percutaneous Coronary Intervention and Acute Coronary Syndrome

2003 ◽  
Vol 37 (6) ◽  
pp. 860-875 ◽  
Author(s):  
Michael A Crouch ◽  
Jean M Nappi ◽  
Kai I Cheang
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
High Risk ◽  
Coronary Intervention ◽  
Data Sources ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Percutaneous Coronary

OBJECTIVE: To review the contemporary role of the glycoprotein (GYP) IIb/IIIa receptor inhibitors abciximab, eptifibatide, and tirofiban in patients undergoing percutaneous coronary intervention (PCI) and those with an acute coronary syndrome (ACS), and to provide an algorithm based on currently available evidence for specific agents. DATA SOURCES: Primary articles were identified by a MEDLINE search (1966–January 2003); references cited in these articles provided additional resources. STUDY SELECTION AND DATA EXTRACTION: All of the articles identified from data sources were considered for relevant information; this article primarily addresses large, controlled or comparative studies, and meta-analyses. DATA SYNTHESIS: The role of GYP IIb/IIIa inhibitors in patients undergoing PCI and those with ACS has progressed markedly. To date, abciximab has the most robust data in patients undergoing PCI, particularly high-risk individuals. In PCI patients with lower risk (e.g., elective stenting), eptifibatide is a reasonable first-line option. Data do not support tirofiban for routine use in patients undergoing PCI. For individuals with signs and symptoms of ACS, specifically unstable angina or non–ST-segment elevation myocardial infarction (MI), eptifibatide or tirofiban is recommended in high-risk patients when a conservative approach is used (PCI is not planned). Abciximab is not recommended in this situation. In patients with ST-segment elevation MI (STEMI), abciximab is the only GYP IIb/IIIa inhibitor evaluated in large, well-designed investigations. For medical management in combination with a fibrinolytic agent, the role of abciximab remains unclear. For patients undergoing primary PCI for the management of STEMI, the available evidence supports the use of abciximab, albeit further investigation is warranted. CONCLUSIONS: The role of GYP IIb/IIIa inhibitors in clinical cardiology continues to evolve. Choice of the agent depends on situation of use, patient-specific characteristics and risk stratification, and, in the case of ACS, chosen management strategy (medical management or intervention).

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