scholarly journals Registry Study of Clinical Data and in Hospital Outcome in Patients Admitted with Acute Coronary Syndrome at Tanta University Hospital in 2019

2020 ◽  
pp. 65-77
Author(s):  
Doaa Abdelfattah Helal ◽  
Fatma Aboalsaoud Taha ◽  
Sameh Samir Khalel ◽  
Mohammed Elsayed El Setiha
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Previous History ◽  
University Hospital ◽  
Hospital Death ◽  
Killip Class ◽  
Hospital Outcome ◽  
Coronary Syndrome ◽  
History Of

Background: A quick but thorough assessment of the patient’s history and findings on physical examination, electrocardiography, and cardiac biomarker tests permit accurate diagnosis and aid in early risk stratification. This work aimed to analyze the diagnostic and prognostic tools, the modalities of management, and the hospital outcome of patients with acute coronary syndrome (ACS) at Tanta University Hospital in one year. Methods: This ACS registry at Tanta university hospital is a prospective observational registry for 200 consecutive admitted patients with proven ACS from January 2019 to January 2020. Results: A higher percent of hypertension, family history of ischemic heart disease and SCD, previous history of chronic kidney disease (CKD), and lower percent of a previous history of IHD in STEMI compared to NSTEMI/UA. In-hospital death, in-hospital reinfarction, and reduced ejection fraction are higher in STEMI than in NSTEMI/UA patients. (P value = 0.015, 0.018 and 0.001 respectively) without significant differences regarding in-hospital congestive heart failure (CHF) and ischemic stroke. History of CKD, higher Killip class, and in-hospital stroke were independently affecting in-hospital mortality. Also, the history of higher Killip class was independently affecting in-hospital reinfarction and in-hospital CHF. Old age and occurrence of in-hospital reinfarction were independently affecting in-hospital stroke. Conclusion: Hypertension, diabetes, dyslipidemia, and smoking are the major risk factors for ACS so, controlling these risk factors will improve in-hospital outcomes. In STEMI, most patients underwent PPCI, which was reflected in the outcome. In NSTEMI/UA patients, both conservative and invasive management was done, taking into consideration the risk stratification of each patient, making management easier and with a good outcome.

scholarly journals Metabolic Risk Factors and Outcomes in Acute Coronary Syndrome

2020 ◽  
pp. 46-50
Author(s):  
Ritu Attri ◽  
Harsimran Kaur ◽  
Raminderpal Singh Sibia ◽  
Mandip Singh Bhatia
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Positive Family History ◽  
Developed Countries ◽  
P Value ◽  
Health Crisis ◽  
Female Ratio ◽  
Medical College ◽  
Coronary Syndrome ◽  
History Of

Introduction: CAD is the most common cause of mortality in India. It is a common multifarious public health crisis today and a leading cause of morbidity and mortality in both developing and developed countries. Hence, understanding the predominant risk factors among the Indian population is important. Materials and Methods: This was a hospital based age and sex matched case control study, carried out at Government Medical College and Rajindra Hospital Patiala. A total of 100 patients of Acute coronary syndrome were studied. Patients and controls were enquired about  the presence of cardiometabolic risk factors and the significance of association of these risk factors with the occurrence of Acute coronary syndrome was given by p value of  <0.05. Results: Majority of the cases were in the age group 61-70 years (32%) with male to female ratio  of 1.25:1. Significant association was found between ACS and risk factors like smoking, positive family history of IHD, hypertension, diabetes, dyslipidemia, waist hip ratio and body mass index. Overall, most common outcome of ACS in the present study was NSTEMI (45%) followed by STEMI (35%) followed by Unstable angina (20%). Conclusion: Significant association was found between smoking and occurrence of STEMI and significant association was found between Hypertension and occurrence of NSTEMI.

scholarly journals Hepatitis C in pregnancy: an observational study highlighting its association with maternal parameters

2019 ◽  
Vol 8 (1) ◽  
pp. 344
Author(s):  
Bushra . ◽  
Ambreen Ghori ◽  
Azra Ahmed ◽  
Najma Dalwani ◽  
Mushtaque Ali Shah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Previous History ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Prior History ◽  
Singleton Pregnancy ◽  
Cross Sectional ◽  
History Of

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.

scholarly journals Acute coronary syndrome in elderly – risk factors and in-hospital outcome

2018 ◽  
Vol 5 (2) ◽  
pp. 77-81
Author(s):  
Dr. Mary Grace ◽  
◽  
Dr. Mukundan Chelakkat ◽  
Dr. Anjana Asokan ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Hospital Outcome ◽  
Coronary Syndrome

Peripheral artery disease in outpatients with a recent history of acute coronary syndrome or at high atherothrombotic risk

Vascular ◽  
2020 ◽  
pp. 170853812093892 ◽  
Author(s):  
Carlos Cantú-Brito ◽  
Erwin Chiquete ◽  
Javier F Antezana-Castro ◽  
Liz Toapanta-Yanchapaxi ◽  
Ana Ochoa-Guzmán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Peripheral Artery Disease ◽  
Case Fatality ◽  
Coronary Risk ◽  
Vascular Risk ◽  
Peripheral Artery ◽  
Coronary Syndrome ◽  
History Of ◽  
Artery Disease

Objectives The frequency and implications of peripheral artery disease (PAD) in some risk groups are not entirely characterized in Latin America. We studied PAD prevalence, risk factors, and six-month outcomes in stable outpatients with a history of a recent acute coronary syndrome (ACS), or at high coronary risk. Methods We recruited 830 outpatients in 43 Mexican sites (median age: 64.8 years; 57.8% men). Inclusion criteria were age >18 years, and ACS within 30 days, or age <55 years plus ≥2 major vascular risk factors, or age ≥55 years plus ≥1 vascular risk factors. Patients received standardized assessments at baseline and six-month follow-up for medical history, ankle-brachial index (ABI), and the Edinburgh Claudication Questionnaire (ECQ). Results ABI <0.8 was found in 10.5%, <0.9 in 22.5%, >1.3 in 4.8%, and >1.4 in 3.6%, without differences according to sex or selection criteria. Positive ECQ was found in 7.6%. ABI <0.9 was directly associated with age, diabetes, ACS, and chronic kidney disease, but inversely associated with BMI >27. The six-month case-fatality and atherothrombotic events rates were 1.6% and 3.6%, respectively. In patients with ABI <0.9 and ABI <0.8, the six-month case-fatality rates were 2.5% ( p =  0.27) and 5.4% ( p =  0.03), respectively. In a Cox proportional-hazards model, baseline factors associated with death were age ≥65, ABI <0.8, and ACS. Conclusions Subclinical PAD is more common than symptomatic claudication in high-risk coronary outpatients. Low ABI is associated with reduced short-term survival in patients with recent ACS or at high coronary risk.

scholarly journals Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)—Two-Year Follow-Up Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Leila Yazdanpanah ◽  
Hajieh Shahbazian ◽  
Iraj Nazari ◽  
Hamid Reza Arti ◽  
Fatemeh Ahmadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Previous History ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Population Based ◽  
University Hospital ◽  
Foot Deformity ◽  
History Of

Aim/Introduction. This study was carried out to assess the incidence and risk factors of diabetic foot ulcer (DFU). Materials and Methods. In this prospective cohort study in a university hospital, all the participants were examined and followed up for new DFU as final outcome for two years. To analyze the data, the variables were first evaluated with a univariate analysis. Then variables with P value < 0.2 were tested with a multivariate analysis, using backward-elimination multiple logistic regression. Results. Among 605 patients, 39 cases had DFU, so we followed up the remaining 566 patients without any present or history of DFU. A two-year cumulative incidence of diabetic foot ulcer was 5.62% (95% CI 3.89–8.02). After analysis, previous history of DFU or amputation [OR = 9.65, 95% CI (2.13–43.78), P value = 0.003], insulin usage [OR = 5.78, 95% CI (2.37–14.07), P value < 0.01], gender [OR = 3.23, 95% CI (1.33–7.83), P value = 0.01], distal neuropathy [OR = 3.37, 95% CI (1.40–8.09), P value = 0.007], and foot deformity [OR = 3.02, 95% CI (1.10–8.29), P value = 0.032] had a statistically significant relationship with DFU incidence. Conclusion. Our data showed that the average annual DFU incidence is about 2.8%. Independent risk factors of DFU development were previous history of DFU or amputation, insulin consumption, gender, distal neuropathy, and foot deformity. These findings provide support for a multifactorial etiology for DFU.

scholarly journals Association of Haemoglobin and C-Reactive Protein level with Different Risk Factors among Acute Coronary Syndrome Patients

2019 ◽  
Vol 5 (2) ◽  
pp. 156-160
Author(s):  
Md Mahboob Morshed ◽  
Md Joynul Islam ◽  
ATM Ashadullah ◽  
Khondker Shaheed Hussain ◽  
Mohammad Ahtashamul Haque
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Group 4 ◽  
History Of ◽  
Study Population ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Different risk factors may be related with the haemoglobin and CRP level among the acute coronary syndrome patients. Objective: The purpose of the present study was to see the association of haemoglobin and CRP level with different type of risk factors among the acute coronary syndrome patients. Methodology: This cross-sectional study was conducted in the Department of Cardiology at Mymensingh Medical College, Mymensingh, Bangladesh from December 2010 to November 2011 for a period of two (02) years. Patients of ACS who were presented within 12 hours of chest pain were included as study population. Study population were categorized in four groups according to the level of hemoglobin and C-reactive protein. Age, cardiovascular risks factor, history, family history of cardiovascular disease, treatment history and ECG were taken during admission. Blood sample was collected for baseline laboratory investigations like Troponin-I, Random Blood Sugar (RBS), Blood urea, Serum creatinine, lipid profile, Hemoglobin & CRP level. Sample were then send to standard laboratory/Biochemistry department of MMCH. Result: The mean age of the population was 52.18±8.88 years. Smoking was the highest percentage in Group 1 which was 54(50.0%) cases (P=0.001). Hypertension was found most common in group 1 (47.6%), Group 2 (33.3%), Group 3 (10.7%) and Group 4 (8.3%). Smoking (p=0.001) and hypertension (p=0.016) was found statistically significant. Diabetes was found in Group 1 (37.7%), Group 2 (43.5%), Group 3 (11.6%) and Group 4 (7.2%). Group 1 (50%) and Group 2 (50%) patients were dyslipidaemic. Family history of IHD was present group-1 (36.8%), Group 2 (44.7%), Group 3 (73.2%) and Group 4 (53%). Among the smoker patient 65.6% cases had CRP level ˃12 mg/l; 39.8% cases had CRP level ˂12mg/L. Among the nonsmoker 34.4% cases had CRP level ˃12mg/l and 60.2% cases had CRP level ˂12mg/L. The finding was statistically significant. Conclusion: In conclusion haemoglobin and CRP level is associated with different type of risk factors among the acute coronary syndrome patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 156-160

Evaluating Mortality Rate and Associated Parameters in Patients with Acute Coronary Syndrome

2020 ◽  
Vol 20 (3) ◽  
pp. 221-226
Author(s):  
Alireza Gheini ◽  
Ali Pooria ◽  
Afsoun Pourya
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Acute Coronary Syndrome ◽  
Mortality Rate ◽  
Winter Season ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Killip Class ◽  
Coronary Syndrome ◽  
Increased Risk

Background: Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and is characterized by unstable angina or acute myocardial infarction. The aim of this study is to evaluate the clinical characteristics of patients who died of ACS. Methods: In this cross-sectional study, 1000 patients presenting ACS were included. Data and records of these patients were evaluated for parameters such as; deceased status, age, gender, diagnosis, ECG, common complaints, associated risk factors, Killip class, pulse, blood pressure, geographic setup (urban or rural), complications and season in which the disease was presented. Statistical analysis was performed on the data obtained using SPSS-win software. Results: The mortality rate among ACS patients in our study was 7.1%. Of these patients, AMI was the most prevalent diagnosis and chest pain was the most common complaint. Furthermore, low blood pressure, advanced age, increased pulse rate and fall/winter season were associated with the increased risk of mortality. ST deviation was the most seen ECG finding and most of the mortalities were within the 24 hours of admission. Conclusion: Our study reports risk factors associated with mortality in ACS patients. Advanced and timely therapeutic measurements are likely to reduce the incidence of mortality in these patients.

Vitreous Haemorrhage Associated with Combined Antiplatelet Agents

2020 ◽  
Author(s):  
Machtache Rihab
Keyword(s):  
Previous History ◽  
Antiplatelet Agents ◽  
Posterior Pole ◽  
Vitreous Haemorrhage ◽  
University Hospital ◽  
Coronary Syndrome ◽  
System Disease ◽  
History Of ◽  
St Elevation ◽  
Lost To Follow Up

We present here a rare case vitreous Haemorrhage associated with combined antiplatelet agents: the aspirin and clopidogrel. The patient was a Moroccan female aged 44 years old, with no previous history of hypertension or diabetes and takes no drugs. She has been admitted to the emergencies of our teaching university hospital for an acute coronary syndrome ST-elevation anterior. Chromatography was performed after the admission. She benefited from the successful stenting of the anterior interventricular artery. The patient was put on double antiplatelet agents for 12 months: aspirin and clopidogrel and benefited from system disease review. Unfortunately, the patient was lost to follow up and has continued the treatment for almost 25 months after what she was admitted in the ophthalmic emergencies for sudden reduction of visual acuity of the left eye for what an echography was performed and showed a vitreous Haemorrhage. A complimentary MRI was realized in T2 sequences, showing normal massless orbits at the posterior pole that can explain the vitreous Haemorrhage.

scholarly journals Epidemiology and risk factors of patients with types of acute coronary syndrome presenting to a tertiary care hospital in Sri Lanka

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Udaya Ralapanawa ◽  
Pallegoda Vithanage Ranjith Kumarasiri ◽  
Kushalee Poornima Jayawickreme ◽  
Prabashini Kumarihamy ◽  
Yapa Wijeratne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Sri Lanka ◽  
Unstable Angina ◽  
Stable Angina ◽  
Strong Association ◽  
Coronary Syndrome ◽  
History Of ◽  
St Elevation

Abstract Background Acute Coronary Syndrome (ACS) is one of the leading causes of death worldwide and studies have shown higher mortality rates and premature death in South Asian countries. The occurrence and effect of risk factors differ by type ofACS.Epidemiological studies in the Sri Lankan population are limited. Methods This is a cross sectional descriptive study conducted at the Teaching Hospital Peradeniya, Sri Lanka among patients presenting with ACS. Data was collected by an interviewer administered structured questionnaire and epidemiological patterns and risk factors were analyzed. Results The sample of 300 patients had a mean age of 61.3+/− 12.6 and male sex showed higher association with all three type of ACS compared to female with a P value of 0.001. This study showed higher mean age of 62.2 ± 11.4 years amongst unstable angina (UA) patients and 61.9 ± 14.5 years amongst non ST elevation myocardial infarction (NSTEMI) patients compared to 59.2 ± 11.2 years for ST elevation myocardial infarction (STEMI) patients with no significant statistical difference (P = 0.246). Approximately 55.8% STEMI patients, 39.8% UA and 35.5% NSTEMI patients were smokers indicating a significant association between smoking and STEMI (P = 0.017). Nearly 54.5% STEMI, 35.4% UA and 32.7% NSTEMI patients consumed alcohol and there was a very strong association between alcohol consumption and STEMI (P = 0.006). Almost 51.8% NSTEMI patients, 47.8% UA patients and 29.9% STEMI patients had hypertension(HT) (P = 0.008) indicating significant association of HT with UA and NSTEMI. About 33.6% UA patients and 30.0% NSTEMI patients had DM whilst only 22.1% of STEMI patients had DM of no significance (p = 0.225). Around 15.0% patients with UA, 25.5% with NSTEMI and 11.7% with STEMI had dyslipidemia (P = 0.032). There was a very strong association between a past history of ACS or stable angina with NSTEMI and UA (P = 0.001). Conclusion Smoking and alcohol abuse are significantly associated with STEMI.Patients with NSTEMI or Unstable Angina had higher rates of hypertension and were more likely to have a history of ACS or stable angina than STEMI patients. Patients with NSTEMI were more likely than patients with STEMI or UA to have dyslipidemia.

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