Abstract 1525: High Density Lipoprotein Cholesterol is Protective Against the Development of Cardiac Rhythm Disturbances in the Non-ST Segment Elevation Acute Coronary Syndrome

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Nick Kalayeh ◽  
Yosef Kahn ◽  
Alon Yarkoni ◽  
Francisco J Gonzalez ◽  
Akil Loli ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cardiac Rhythm ◽  
Density Lipoprotein ◽  
Ischemic Heart ◽  
Lipoprotein Cholesterol ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

INTRODUCTION: Many studies have demonstrated that reduced high-density lipoproteins (HDL) levels and elevated triglyceride (TG)/HDL ratio correlate with the development of chronic ischemic heart disease. The role of HDL and the development of cardiac rhythm disturbances in the non-ST segment elevation acute coronary syndrome (ACS) is unclear. HYPOTHESIS: We assessed the hypothesis that HDL might be protective against development of cardiac rhythm disturbances. Additionally, any protective effect was compared with TG/HDL and LDL/HDL in this setting. METHODS: A total of 6881 patients who presented during 2000–2003 with non-ST segment elevation ACS had fasting lipid panels collected within the first 24 hours of admission. Patients were followed for the development of rhythm disturbances of up to 6 years after initial presentation, with a mean of 1269 days. These patients were further separated into diabetic and nondiabetic groups. RESULTS: After adjustment for ischemic heart disease, congestive heart failure, stroke, peripheral vascular disease, hypertension, low density lipoprotein cholesterol, triglycerides, age, and body mass index, higher HDL levels were found to be independently protective against developing atrial fibrillation and other cardiac rhythm disturbances. TG/HDL and LDL/HDL were also protective of cardiac arrhythmias but not with the same power as low HDL (HDL > 31mg/dl, HR = 3.69, 95% CI=3.01– 4.53, P < 0.05). CONCLUSIONS: Based on the above results, patients with lower HDL levels during hospitalizations with non-ST segment elevation ACS have a greater chance of developing cardiac rhythm disturbances independent of other risk factors. Although higher TG/HDL and LDL/HDL are also predictive, lower HDL is associated with highest OR for the development of cardiac arrhythmia among diabetic and non-diabetic patients with non-ST elevation with ACS.

scholarly journals EVALUATION OF THE INTERNAL PICTURE OF HEALTH IN PATIENTS WITH ACUTE CORONARY SYNDROME IN PRESENTING WITHOUT ST-SEGMENT AFTER PERCUTANEOUS CORONARY INTERVENTIONS AND IN THE PROCESS OF REHABILITATION

2019 ◽  
Vol 3 ◽  
pp. 9-17
Author(s):  
Roksolana Nesterak
Keyword(s):  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Conservative Treatment ◽  
Ischemic Heart Disease ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Life Questionnaire ◽  
Actual Problem ◽  
Coronary Syndrome ◽  
St Segment

Ischemic heart disease remains an actual problem of modern clinical and rehabilitation medicine. One of the forms of ischemic heart disease (IHD) is an acute coronary syndrome (ACS) in patients presenting without persistent ST-segment, the treatment of which involves the use of conservative treatment and reperfusion techniques. An integral part of the management of patients after acute coronary syndrome is rehabilitation and restoration with the search for methods of changing the attitude of the patient to his health. To improve the rehabilitation of patients it is important to assess the internal picture of health with the formation of the correct attitude of the patient to his health. Aim. To study the peculiarities of the components of the internal picture of health in patients with acute coronary syndrome in patients presenting without persistent ST-segment in the process of treatment and rehabilitation. Materials and methods. There were examined 135 patients with ACS presenting without persistent ST-segment, who were divided into the groups depending on the treatment performed; 60 patients with conservative treatment tactics and 75 patients with the performed PCI. The analysis of the internal picture of health was carried out with the help of methods: hospital scale for the detection of anxiety and depression (HADS); patient health questionnaire (PHQ-9); scale for measuring the level of reactive (situational) and personality anxiety of Spielberg-Hanin; SF-36; indicators of the Seattle Quality of Life Questionnaire for Patients with Angine Pectoris (Seattle Angina Questionnaire - SAQ). Results. The study of the internal picture of health in patients with ACS presenting without persistent ST-segment showed low levels of emotional, sensory, cognitive, value-motivational, behavioral components on the appropriate scales, which also depend on the method of treatment used. The revealed peculiarities of patients with ACS presenting without persistent ST-segment need to increase the knowledge of the patient about the disease and the importance of rehabilitation measures. Conclusions. In assessment of the internal picture of health in patients with ACS presenting without persistent ST-segment after transcutaneous coronary intervention and in the process of rehabilitation, it has been determined that the course of ischemic heart disease in patients with ACS presenting without persistent ST-segment, both during conservative treatment and in the course of PCI at the stages of rehabilitation, is accompanied by significant changes of the internal picture of health (IPH); the most significant changes in patients with ACS presenting without persistent ST-segment is the value-motivational and behavioral components of the internal picture of health. In order to increase the effectiveness of rehabilitation after ACS, it is advisable to apply programs that will significantly affect the positive changes in the rehabilitation of patients with ACS.

scholarly journals ST segment elevation and depression, and T-wave changes as electrophysiological signs of metabolic disorders with lipid and non-lipid risk factors for ischemic heart disease in the 25–44-year-old population

2021 ◽  
Vol 10 (4) ◽  
pp. 29-38
Author(s):  
N. A. Kuzminykh ◽  
L. V. Shcherbakova ◽  
V. S. Shramko ◽  
D. V. Denisova ◽  
Yu. I. Ragino
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Metabolic Disorders ◽  
Density Lipoprotein ◽  
Ischemic Heart ◽  
St Segment Elevation ◽  
T Wave ◽  
St Segment ◽  
St Elevation

Aim. To study the associations of electrophysiological signs of metabolic disorders with lipid and non-lipid risk factors in the urban 25–44-year-old population.Methods. A population survey (random sample) of Novosibirsk residents aged 25–44 years (656 men, 783 women) was conducted. The concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and triglycerides were determined. Systolic / diastolic blood pressure, body mass index, presence of arterial hypertension, and smoking status were evaluated. The following electrocardiographic markers of metabolic disturbances were analyzed: baseline non-ischemic ST elevation depression >0.5 mm, baseline ST elevation >0.5 mm, and T-wave changes (flattening, amplitude reduction, inversion).Results. ST segment depression was detected in 4.2% of subjects (5.8% women, 2.4% men (p = 0.001)). ST segment elevation was detected in 28.5% of subjects (17.5% women, 41.6% men (p<0.001)). T-wave changes were detected in 18.9% of subjects (14.2% women, 24.5% men (p<0.001)). It was noted that men with elevated LDL-C levels and hypertension were more likely to have ST segment depression (1.4 and 1.9 times, respectively) than men without these abnormalities. In the general population, people with elevated LDL-C levels were 1.2 times more likely to have ST segment depression. Among men with ST segment elevation the concentration of LDL-C in the blood was 1.06 times higher than in men without ST segment elevation. People with a higher body mass index were 1.15 and 1.3 times more likely to have a T-wave change (in the general and female population, respectively). In the general population with T-wave changes, waist circumference and systolic blood pressure level were 1.02 and 1.02 times higher, respectively.Conclusion. ST segment elevation and depression, and T-wave changes are associated with lipid and non-lipid risk factors for ischemic heart disease. The data obtained indicate a potentiating effect of metabolic disorders in the body on the development of risk factors for ischemic heart disease and metabolic cardiomyopathy.

scholarly journals The Role of Ticagrelor in STEMI Fibrinolytic and Its Rationale to Utilize for Indonesian Patients

2019 ◽  
Vol 40 (4) ◽  
Author(s):  
Daniel Tobing ◽  
Dafsah Juzar ◽  
Achmad Fauzi Yahya ◽  
Antonia Anna Lukito ◽  
Doni Firman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Platelet Inhibition ◽  
Fibrinolytic Therapy ◽  
Ischemic Heart ◽  
Primary Pci ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

Worldwide, ischemic heart disease is the most common cause of death and its frequency is increasing. ST-segment elevation myocardial infarction or STEMIis as form of ischemic heart disease with the highest mortality rate. Based on ESC (European Society of Cardiology) guideline 2017 for STEMI management, reperfusion therapywhich is primary PCI strategy is recommended over fibrinolysis within induced timeframes, but if timely primary PCI cannot be performed after STEMI diagnosis, fibrinolytic therapy is recommended within 12 hours of symptom onset in patients without contraindications. In fibrinolytic therapy, oral aspirin should be given, and Clopidogrel is indicated as an addition to aspirin. Although Clopidogrel is a recommended P2Y12receptor inhibitorin fibrinolytic therapy,PERKI guideline 2018 in ACS management also mention thatswitching to Ticagrelor can be considered in patients whowillundergo PCI treatmentafter fibrinolytic. In PLATO study, patients who have acute coronary syndrome with or without ST-segment elevation, treatment with ticagrelor as compared with clopidogrel significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke. However, patients who received fibrinolytic therapy within 24 hours before randomization were excluded. WhileinSET-FAST study, Ticagrelor provides more prompt and potent platelet inhibition compared with Clopidogrel in patients undergoing PCI within 24 hours of receiving fibrinolysis for STEMI. TREAT study was conducted to evaluate the safety of ticagrelor in STEMI patients receiving fibrinolytic therapy within 24 hours.TREAT study concluded, at 30 days observation, in patients younger than 75 years with STEMI, delayed administration of Ticagrelor after fibrinolytic therapy was noninferior to Clopidogrel for TIMI major bleeding. Based on the result from PLATO study and preliminary TREAT study result on 30 days, the use of Ticagrelor within 24 hours after fibrinolytic therapy can be considered with comparable safety profile to Clopidogrel.   Keywords: STEMI, fibrinolysis, ticagrelor

IMPACT OF RISK FACTORS OF ISCHEMIC HEART DISEASE ON THE DEVELOPMENT OF ACUTE CORONARY SYNDROME, PLATELET ULTRASTRUCTURE, AND ASPIRIN RESISTANCE

2019 ◽  
Vol 72 (11) ◽  
Author(s):  
Yulian H. Kyyak ◽  
Olga Yu. Barnett ◽  
Marta P. Halkevych ◽  
Olha Ye. Labinska ◽  
Hryhoriy Yu. Kyyak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Aspirin Resistance ◽  
Ischemic Heart ◽  
Coronary Syndrome

IMPACT OF RISK FACTORS OF ISCHEMIC HEART DISEASE ON THE DEVELOPMENT OF ACUTE CORONARY SYNDROME, PLATELET ULTRASTRUCTURE, AND ASPIRIN RESISTANCE

2019 ◽  
Vol 72 (11) ◽  
Author(s):  
Yulian H. Kyyak ◽  
Olga Yu. Barnett ◽  
Marta P. Halkevych ◽  
Olha Ye. Labinska ◽  
Hryhoriy Yu. Kyyak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Aspirin Resistance ◽  
Ischemic Heart ◽  
Coronary Syndrome
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