The Association between hs-CRP Levels with GRACE Score in Acute Coronary Syndrome Patients in H. Adam Malik Medan Central General Hospital

2021 ◽  
Vol 8 (8) ◽  
pp. 220-226
Author(s):  
Putri Gaby Yosephine ◽  
Refli Hasan ◽  
Rahmad Isnanta
Keyword(s):  
Acute Coronary Syndrome ◽  
General Hospital ◽  
Spearman Correlation ◽  
Correlation Test ◽  
Coronary Syndrome ◽  
Wide Range ◽  
Significant Difference ◽  
Spearman Correlation Test ◽  
Hs Crp ◽  
Grace Score

Objective: Acute coronary syndrome (ACS) describes a wide range of myocardial ischemia, which is always associated with the rupture of atherosclerotic plaques in coronary arteries. CRP has been shown to be a risk predictor of ACS. GRACE score has been associated with predicting early and late death in ACS patients. Therefore, this study aim to investigate the association between high sensitivity C-reactive protein (hs-CRP) levels with GRACE score in ACS patients. Methods: This study was a retrospective analytic study. The study population was acute coronary syndrome patients in central general hospital of H. Adam Malik, Medan city and 51 patients who met the inclusion and exclusion criteria. Data analysis was calculated using univariate and bivariate analysis. A correlation test was carried out using Spearman correlation test to determine the association between hs-CRP levels with GRACE score in ACS patients. Results: There were 51 samples included in the study. There was a significant difference (p = 0.005) in the mean hs-CRP levels in UAP, NSTEMI, and STEMI subjects. In contrast, there was no significant difference in GRACE score among the three ACS diagnoses. For the association of hs-CRP levels with GRACE score in all subjects, the Spearman correlation test showed a significant correlation between hs-CRP levels with GRACE score (p < 0.001) with a correlation coefficient (r) of 0.588. Conclusion: There was a significant association between serum hs-CRP levels with GRACE score and the higher hs-CRP levels, followed by a higher GRACE score. Keywords: Acute coronary syndrome, GRACE score, hs-CRP.

scholarly journals The Effect of Technical Competence in Balance Elements of Rhythmic Gymnastics on the Sportive Success of Taekwondo Poomsae Athletes

2018 ◽  
Vol 6 (9) ◽  
pp. 136
Author(s):  
Sezen Çimen Polat
Keyword(s):  
Technical Competence ◽  
Spearman Correlation ◽  
Balance Test ◽  
Correlation Test ◽  
Rhythmic Gymnastics ◽  
Significant Difference ◽  
Spearman Correlation Test ◽  
Level Of Significance ◽  
The Relationship

This study aims to investigate the effect of technical competence in certain balance elements, an important parameter in rhythmic gymnastics, on sportive success in taekwondo poomsae athletes and the relationship between them. The study was conducted on 12 female taekwondo athletes (age: 17.6±1.2; height: 159.26±3.1 cm; weight: 50.79±1.82 kg; BMI: 20.88±0.98 kg/m2). The participants were selected from successful athletes who were in the top 6 in their own category in the national taekwondo competition held this year. The athletes performed 6 balance elements in rhythmic gymnastics, i.e. side passé (SP), 90° forward (90°F), side split with hand support (SSWHS), Arabesque with trunk forward (A), Cossack (C) and free leg to the side (FLS), and the Y balance test. The relationship between these balances that were assessed by 3 international judges and success rating was identified using the Spearman correlation test. The level of significance was accepted as p<0.05. As result, a statistically significant difference was found between side passé and split with hand support, balances used in rhythmic gymnastics, and success ratings (p<0.05). While no statistically significant difference was found between other balances, i.e. 90° forward, arabesque with trunk forward, cossack and free leg to the side and sportive success, there was a high relationship between them. In addition, there was no statistically significant difference between sportive success and right and left anterior (RAB, LAB) posteromedial (RPMB, LPMB) and posterolateral (RPLB, LPLB) reach distances. In conclusion, since the study found a high relationship between sportive success and technical competence of poomsae athletes in the two technical side balances, it is suggested that basic gymnastics training can be effective in improving the balancing skills of taekwondo poomsae athletes.

scholarly journals Intensive Statin Therapy in NSTE-ACS Patients Undergoing PCI: Clinical and Biochemical Effects

2015 ◽  
Vol 42 (6) ◽  
pp. 528-536 ◽  
Author(s):  
Mohamed Shehata ◽  
George Fayez ◽  
Ahmed Nassar
Keyword(s):  
Acute Coronary Syndrome ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cardiac Events ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events ◽  
Significant Difference ◽  
Hs Crp ◽  
Group B

Early initiation of statin therapy in acute coronary syndrome patients has a favorable prognostic impact because of its anti-inflammatory and antithrombotic properties. In this study, we explored the effect of atorvastatin-loading, followed by intensive atorvastatin therapy, on clinical and biochemical outcomes in non-ST-segment-elevation acute coronary syndrome patients who were scheduled for percutaneous coronary intervention. We prospectively enrolled 140 patients (mean age, 56 ± 9 years, 68% men). Once eligible, patients were randomly assigned to receive either a moderate 20-mg daily dose of atorvastatin (Group A) or a 160-mg loading dose followed by an intensified 80-mg daily dose (Group B). High-sensitivity C-reactive protein (hs-CRP) levels were recorded before and after intervention. Evaluation after 6 months included hs-CRP levels, left ventricular systolic function, and major adverse cardiac events. We found no significant difference between the 2 groups in regard to the interventional data. However, blood sampling after coronary intervention, and again 6 months later, revealed a significant decline in mean hs-CRP level among Group B patients (P &lt;0.001). Moreover, patients in Group B manifested a higher left ventricular ejection fraction than did patients in Group A (P &lt;0.05). After 6 months, we found no significant difference between groups in the incidence of major adverse cardiac events. We conclude that intensive atorvastatin therapy in non-ST-segment-elevation acute coronary syndrome patients is associated with lower hs-CRP levels and with higher left ventricular ejection fraction after 6 months, with no significant impact on adverse cardiac events.

scholarly journals Correlation between Changes in Serum RBP4, hs-CRP, and IL-27 Levels and Rosuvastatin in the Treatment of Coronary Heart Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yali Wang ◽  
Changrui Zhou ◽  
Tianlian Yu ◽  
Feng Zhao
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Control Group ◽  
Spearman Correlation ◽  
Gensini Score ◽  
Routine Treatment ◽  
Positive Correlation ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Hs Crp

Objective. To investigate the correlation between changes in serum RBP4, hs-CRP, and IL-27 levels and rosuvastatin in the treatment of coronary heart disease (CHD). Methods. One hundred and twenty patients with CHD admitted in our hospital were selected as the research object, including 60 patients with acute coronary syndrome as the ACS group, and 60 patients with stable angina as the SA group. Another 60 patients without CHD who were examined in our hospital at the same time were included in the non-CHD group. The patients with CHD were further divided into the control group (CG) (n = 42, with routine treatment) and the study group (SG) (n = 78, with routine treatment and rosuvastatin) to measure serum RBP4, hs-CRP, and IL-27 levels and analyze the correlation between each index and rosuvastatin in the treatment of CHD. Results. After retrospective analysis, no significant difference was found among the ACS group, the SA group, and the non-CHD group ( P  > 0.05). As for serum RBP4, hs-CRP, and IL-27 levels, ACS group > SA group > non-CHD group, with obvious differences among groups ( P  < 0.05). After Spearman correlation analysis, a positive correlation was observed between Gensini score and serum RBP4, hs-CRP, and IL-27 levels in patients with CHD ( P  < 0.05). After treatment, serum RBP4, hs-CRP, and IL-27 levels were gradually reduced. At 4 weeks after treatment, serum RBP4, hs-CRP, and IL-27 levels of the CG and the SG were decreased conspicuously, and compared with the control, each index of the SG was obviously lower ( P  < 0.05). Conclusion. Serum RBP4, hs-CRP, and IL-27 play an important role in the occurrence and development of CHD, with a positive correlation to the Gensini score, which can indicate the severity of cardiovascular disease to a certain extent. Meanwhile, rosuvastatin can remarkably reduce serum RBP4, hs-CRP, and IL-27 levels, which is of significance for prognosis.

scholarly journals Predictors for Long-Term Prognosis after Acute Coronary Syndrome

2021 ◽  
Vol 14 (1) ◽  
pp. 31-46
Author(s):  
Krastina I. Doneva-Basheva ◽  
Damyan P. Petrov ◽  
Tatyana I. Vlaykova ◽  
Snezhana T. Tisheva
Keyword(s):  
Acute Coronary Syndrome ◽  
Regression Analysis ◽  
Systolic Function ◽  
Developed Countries ◽  
Elderly Age ◽  
Term Survival ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Grace Score

Summary Cardiovascular diseases (CVD) are the leading cause of invalidity and death in developed countries. Among them, the main cause of death is coronary artery disease. In this retrospective study, 172 patients with acute coronary syndrome (STEMI, NSTEMI, UA) are included. They had been hospitalized on an emergency basis in the Cardiology Department, Invasive Sector of Prof. Dr. St. Kirkovich Hospital in Stara Zagora, and the Cardiology Hospital -Yambol between January 2009 and February 2010. We found a significant difference in the age at acute coronary syndrome (ACS) occurrence by sex: earlier manifestation was observed in men (p=0.018). The univariant regression analysis showed that elderly age (p=0.005, OR 1.024), glomerular filtration <90 ml/h (p=0.006, OR 0.964), GRACE-score > 140 pt (p<0.001, OR 1.045), HF (Killip class ≥ II) (p=0.002, OR 15.6) and EF<40% (p=0.003, OR 1) were factors for adverse prognosis in the first, fifth and ninth year. Only GRACE-score was an independent predictor of death obtained by multivariate regression analysis in the study (p=0.002, OR 1.052). The factors influencing long-term survival adversely after ACS are age, smoking, chronic kidney disease, previously experienced myocardial infarction, diabetes mellitus, three-vessel coronary disease, and decreased systolic function of the left ventricle, and GRACE > 140 p.

Abstract #511: HS CRP in Acute Coronary Syndrome

2016 ◽  
Vol 22 ◽  
pp. 121-122
Author(s):  
Mukhyaprana Prabhu ◽  
Shyny Reddy ◽  
Ranjan Shetty ◽  
V.B. Mohan ◽  
Weena Stanley
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Syndrome ◽  
Hs Crp

scholarly journals The effect of obstructive sleep apnoea on timing of acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.H Muhmad Hamidi ◽  
H Sani ◽  
M.A Ibrahim ◽  
K.S Ibrahim ◽  
A.B Md Radzi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Systolic Function ◽  
Strong Association ◽  
Multiple Logistic Regression Analysis ◽  
Sleep Apnoea ◽  
Neck Circumference ◽  
Coronary Syndrome ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Background and objective Acute coronary syndrome (ACS) remains the principal cause of death in Malaysia. It is estimated about 20% of ACS occurs at nighttime during sleep between 12am to 6am. Factors associated with nocturnal ACS are unknown. Acute nocturnal pathophysiological response to obstructive sleep apnea (OSA) may increase risk of nocturnal ACS. We hypothesized that OSA risk is associated with timing of ACS onset. Methodology This study included 200 patients with ACS who underwent coronary angiogram for which the time of chest pain onset was clearly identified and divided into 2 groups; nocturnal ACS (12am-5.59am) and non-nocturnal ACS (6am–11.59pm). Two validated questionnaires, STOP-BANG and Epworth Sleepiness Scale (ESS) were self-administered by subjects to determine OSA risk. All subjects timing of ACS onset, OSA risk, demography, anthropometric measurements, comorbidities and echocardiographic characteristics were analyzed. Results Acute coronary syndrome occurs nocturnally in 19% of ACS patients. The prevalence of high risk OSA individuals among ACS patients is 43%. There is significantly higher prevalence of high risk OSA individuals in nocturnal ACS group of 95% compared to 30% of high risk OSA individuals in non-nocturnal ACS group (p=0.001). Nocturnal ACS patients was significantly younger (50.1±8.7yrs, p=0.001), had higher BMI (33.9±4.3kg/m2, p=0.005), waist circumference (106.7±10.3cm, p=0.003) and larger neck circumference (44.6±3.3cm, p=0.001) compared to non-nocturnal ACS group. These groups had similar prevalence of other comorbidities for ACS and showed no significant difference between left and right ventricular systolic function. In multiple logistic regression analysis, the most significant predictors for nocturnal ACS are OSA risk, neck circumference and age. Conclusion There is a strong association between high risk OSA individuals and nocturnal ACS onset. Patient with nocturnal ACS onset should be screened for OSA and prioritized for polysomnography. OSA prevalence according to ACS onset Funding Acknowledgement Type of funding source: None

Comparison of prasugrel and ticagrelor for patient with acute coronary syndrome: a systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L.C.W Fong ◽  
N Lee ◽  
A.T Yan ◽  
M.Y Ng
Keyword(s):  
Acute Coronary Syndrome ◽  
Stent Thrombosis ◽  
Meta Analysis ◽  
Composite Endpoint ◽  
Cardiovascular Death ◽  
Coronary Syndrome ◽  
Primary Composite Endpoint ◽  
Significant Difference ◽  
St Elevation

Abstract Background Prasugrel and ticagrelor are both effective anti-platelet drugs for patients with acute coronary syndrome. However, there has been limited data on the direct comparison of prasugrel and ticagrelor until the recent ISAR-REACT 5 trial. Purpose To compare the efficacy of prasugrel and ticagrelor in patients with acute coronary syndrome with respect to the primary composite endpoint of myocardial infarction (MI), stroke or cardiac cardiovascular death, and secondary endpoints including MI, stroke, cardiovascular death, major bleeding (Bleeding Academic Research Consortium (BARC) type 2 or above), and stent thrombosis within 1 year. Methods Meta-analysis was performed on randomised controlled trials (RCT) up to December 2019 that randomised patients with acute coronary syndrome to either prasugrel or ticagrelor. RCTs were identified from Medline, Embase and ClinicalTrials.gov using Cochrane library CENTRAL by 2 independent reviewers with “prasugrel” and “ticagrelor” as search terms. Effect estimates with confidence intervals were generated using the random effects model by extracting outcome data from the RCTs to compare the primary and secondary clinical outcomes. Cochrane risk-of-bias tool for randomised trials (Ver 2.0) was used for assessment of all eligible RCTs. Results 411 reports were screened, and we identified 11 eligible RCTs with 6098 patients randomised to prasugrel (n=3050) or ticagrelor (n=3048). The included trials had a follow up period ranging from 1 day to 1 year. 330 events on the prasugrel arm and 408 events on the ticagrelor arm were recorded. There were some concerns over the integrity of allocation concealment over 7 trials otherwise risk of other bias was minimal. Patients had a mean age of 61±4 (76% male; 50% with ST elevation MI; 35% with non-ST elevation MI; 15% with unstable angina; 25% with diabetes mellitus; 64% with hypertension; 51% with hyperlipidaemia; 42% smokers). There was no significant difference in risk between the prasugrel group and the ticagrelor group on the primary composite endpoint (Figure 1) (Risk Ratio (RR)=1.17; 95% CI=0.97–1.41; p=0.10, I2=0%). There was no significant difference between the use of prasugrel and ticagrelor with respect to MI (RR=1.24; 95% CI=0.81–1.90; p=0.31); stroke (RR=1.05; 95% CI=0.66–1.67; p=0.84); cardiovascular death (RR=1.01; 95% CI=0.75–1.36; p=0.95); BARC type 2 or above bleeding (RR=1.17; 95% CI =0.90–1.54; p=0.24); stent thrombosis (RR=1.58; 95% CI =0.90–2.76; p=0.11). Conclusion Compared with ticagrelor, prasugrel did not reduce the primary composite endpoint of MI, stroke and cardiovascular death within 1 year. There was also no significant difference in the risk of MI, stroke, cardiovascular death, major bleeding and stent thrombosis respectively. Figure 1. Primary Objective Funding Acknowledgement Type of funding source: None

scholarly journals Usefulness of the PRECISE DAPT score as a predictor of ischaemic stroke after an acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Gonzalez Ferrero ◽  
B.A.A Alvarez Alvarez ◽  
C.C.A Cacho Antonio ◽  
M.P.D Perez Dominguez ◽  
P.A.M Antunez Muinos ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Ischaemic Stroke ◽  
Independent Predictor ◽  
Multivariable Logistic Regression Analysis ◽  
Funding Source ◽  
Independent Factor ◽  
Prediction Ability ◽  
Coronary Syndrome ◽  
Grace Score

Abstract Introduction Ischaemic stroke (IS) risk after acute coronary syndrome is increasing. The aim of our study was to evaluate the stroke rate in a multicentre study and to determine the prediction ability of the PRECISE DAPT score, added to the prediction power of the GRACE score, already demonstrated. Methods This was a retrospective study, carried out in two centres with 5916 patients, with ACS discharged between 2011 and 2017 (median 66±13 years, 27.7% women). The primary endpoint was the occurrence of ischaemic stroke and its risk during follow up (median 5.5, IQR 2.6–7.0). Results A multivariable logistic regression analysis was made, where GRACE (HR 1.01, IC 95% 1.00–1.02) and PRECISE DAPT score (HR 1.03, IC 95% 1.01–1.05) were both an independent predictor of ischaemic stroke after ACS, in a model adjusted by age and AF, which was found to be the independent factor with highest risk (HR 1.67, IC 95% 1.09–2.55). Conclusions GRACE and PRECISE DAPT scores are ischaemic stroke predictors used during follow-up for patients after acute coronary syndrome. We should use both of them not only trying to predict ischaemic/haemorrhagic risk respectively but also as ischaemic stroke predictors. Figure 1. AUC Curves Funding Acknowledgement Type of funding source: None

Impact of cardiac rehabilitation on 3 year outcomes amongst patients after acute coronary syndrome: (ACS) SNAPSHOT ACS follow-up study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Redfern ◽  
K Hyun ◽  
D Brieger ◽  
D Chew ◽  
J French ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Data Linkage ◽  
Research Network ◽  
Funding Source ◽  
Cardiovascular Research ◽  
Coronary Syndrome ◽  
Follow Up Study ◽  
Significant Difference

Abstract Background Cardiovascular disease is the leading cause of disease burden globally. With advancements in medical and surgical care more people are surviving initial acute coronary syndrome (ACS) and are in need of secondary prevention and cardiac rehabilitation (CR). Increasing availability of high quality individual-level data linkage provides robust estimates of outcomes long-term. Purpose To compare 3 year outcomes amongst ACS survivors who did and did not participate in Australian CR programs. Methods SNAPSHOT ACS follow-up study included 1806 patients admitted to 232 hospitals who were followed-up by data linkage (cross-jurisdictional morbidity, national death index, Pharmaceutical Benefit Schedule) at 6 and 36 months to compare those who did/not attend CR. Results In total, the cohort had a mean age of 65.8 (13.4) years, 60% were male, only 25% (461/1806) attended CR. During index admission, attendees were more likely to have had PCI (39% v 14%, p&lt;0.001), CABG (11% v 2%, p&lt;0.001) and a diagnosis of STEMI (21% v 5%, p&lt;0.001) than those who did not attend. However, there was no significant difference between CR attendees/non-attendees for risk factors (LDL-cholesterol, smoking, obesity). Only 19% of eligible women attended CR compared to 30% of men (p&lt;0.001). At 36 months, there were fewer deaths amongst CR attendees (19/461, 4.1%) than non-attendees (116/1345, 8.6%) (p=0.001). CR attendees were more likely to have repeat ACS, PCI, CABG at both 6 and 36 months (Table). At 36 months, CR attendees were more likely to have been prescribed antiplatelets (78% v 53%, p&lt;0.001), statins (91% 73%, p&lt;0.001), beta-blockers (11% v 13%, p=0.002) and ACEI/ARBs (72% v 61%, p&lt;0.001) than non-attendees. Conclusions Amongst Australian ACS survivors, participation in CR was associated with less likelihood of death and increased prescription of pharmacotherapy. However, attendance at CR was associated with higher rates of repeat ACS and revascularisation. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): New South Wales Cardiovascular Research Network, National Heart Foundation

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