scholarly journals Epidemiological profile and predictors of mortality in acute coronary syndrome: a prospective study

2018 ◽  
Vol 5 (3) ◽  
pp. 710
Author(s):  
Madhavi Sarkari ◽  
Mukesh Jaiswal
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Beta Blocker ◽  
Ace Inhibitors ◽  
Troponin I ◽  
Common Symptom ◽  
Duration Of Symptoms ◽  
Coronary Syndrome ◽  
Class Iv

Background: India has shown a rising trend in the prevalence of coronary artery disease (CAD) in urban as well as in rural population. Acute coronary syndrome (ACS) is the main reason for the mortality in India. Study of risk factors and biomarkers is important to catch the diagnosis early in order to decrease the mortality. Objective was to study risk factors and brain natriuretic peptide (BNP), troponine I, and CKMB and their effect on outcome in ACS patients in tertiary hospital.Methods: One hundred and fifty ACS patients were studied in Emergency Department of Medicine, Nehru Hospital, BRD Medical College, Gorakhpur from January 2017 to December 2017. Data on age sex socioeconomic status, medical history, baseline clinical characteristics, time to reach hospital and treatment in hospital, along with biomarkers including BNP, Troponin Iand CKMB was estimated. Baseline ECG was obtained at admission and repeated at 12 -24 hours and every 24 hours thereafter. A 2D Echocardiogram was performed within initial 48-72 hours for analysis of LVEF and wall motion abnormalities.Results: Male (58.7%) preponderance was observed with mean age of 60.12±10.58 years. Most of the patients were from rural areas (87.3%) and had hypertension (44.7%). Chest pain was most common symptom (56%). Most of them had duration of symptoms for 6-12 hours (56%). NSTEMI, STEMI and unstable angina were equally distributed between the genders (p>0.05). Out of 150 patients, 15 (10%) were thrombolysed, 78.52% had RWMA. In-hospital mortality was higher; among the patients of age >75 years (38.5%) (p=0.008), male patient (12.5%) (p>0.05), rural patient (10.7%) (p>0.05), hypertensive patient (17.3%) (p>0.05), patients of Killip class IV (48.3%)(p=0.0001) and patients having severe LVD (33.3%) (p=0.0001). In-hospital mortality was 1.2% and 1.1% among those in whom beta blocker and ACE inhibitors was present (p>0.0001). BNP and CKMB was significantly higher among expired patients (1762.62±1444.89 vs 840.76±1294.82; p=0.001) similarly troponin I was significantly higher among expired patients (67.29±45.63 vs 43.99±41.73; p=0.006) than alive.Conclusions: ACS was more prevalent in male, living in fifth to sixth decade of life, had hypertension. STEMI was more common. Patients on ACE inhibitors and beta-blocker had better outcome. Mortality was higher in patients with Killip’s class IV, higher value of troponin I, age more than 75 years and had hypertension and dyslipidemia.

scholarly journals Level of Serum Uric Acid Along with Other Demographic Parameters in Patients with Acute Coronary Syndrome : A Study of 55 Cases from Chittagong

2014 ◽  
Vol 13 (2) ◽  
pp. 55-58
Author(s):  
Hasan Murad ◽  
Rajiv Dey ◽  
Md Atiquel Islam Chowdhury ◽  
Hridi Hedayet Ullah ◽  
Md Abdur Rouf
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Uric Acid ◽  
Unstable Angina ◽  
Serum Uric Acid ◽  
Troponin I ◽  
Elevated Serum ◽  
Common Finding ◽  
Coronary Syndrome

The association between serum uric acid and ischemic heart disease remains controversial and it has been difficult to identify the specific role of elevated serum uric acid because of its association with established cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidaemia and obesity. Our objective was to study the association of serum uric acid level with confirmed cases of Acute Coronary Syndrome i.e. Unstable Angina, Acute Myocardial Infarction(AMI). The study was conducted in Chittagong Medical College (CMC) & University of Science and Technology(USTC) and nearby diagnostic centre. The study was based on Patients with Acute Coronary Syndrome proved by ECG and/or raised serum Troponin I. The aim of the study was to determine the relationship between serum uric acid and Unstable angina or myocardial infacrtion. There were 35% males & 5% females. The mean age of respondent was 50 years and age ranges from 35 to 70 years. In this study 50 cases of diagnosed myocardial infarction were selected and subsequently investigated with ECG, Radiological and Echocardiographic investigations. Increased serum uric acid levels are a common finding in patients with high blood pressure, insulin resistance, obesity and Cardiovascular disease. The clinical findings, chest X-ray and ECG findings of patients with risk factors for myocardial infarction were extensively studied and the findings are consistent with findings stated in textbooks.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21070

scholarly journals Predictor of in-hospital mortality among acute coronary syndrome patients after treatment with an intra-aortic balloon pump in tertiary Hospital, Thailand

2020 ◽  
Vol 72 (6) ◽  
pp. 462-469
Author(s):  
Chorchana Wichian ◽  
Thotsaporn Morasert ◽  
Surat Tongyoo ◽  
Naruebeth Koson
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Predictive Factors ◽  
Killip Class ◽  
Hemodynamic Support ◽  
Factors Associated ◽  
Coronary Syndrome ◽  
Class Iv

Objective: Intra-aortic balloon pump (IABP), a mechanical hemodynamic support device, had widely been used to treat cardiogenic shock patients for several decades. However, the information about the predictive factors associated with mortality was scarce. This study aims to identify the predictive factors associated with in-hospital mortality in acute coronary syndrome (ACS) patients who performed IABP for their hemodynamic support during admission.Methods: We conduct a retrospective cohort study design. All admission records of ACS patients with IABP at Suratthani Hospital between October 2015 and September 2019 were retrieved.Results: Overall 75 ACS patients with IABP insertion were enrolled. Thirty-one patients died during admission, in-hospital mortality was 41.3%. From the multivariable analysis, we identified 3 predictors associated with in-hospital mortality included cardiac arrest at presentation (adjusted OR [aOR]=11.18, 95%CI: 2.42-51.57, P=0.002), a higher number of inotropes or vasopressors (aOR 6.10, 95%CI 1.36-27.24, P=0.018) and Killip class IV (aOR 5.64, 95%CI 1.01-31.39, P=0.048).Conclusion: ACS patients who required IABP support had high mortality. Cardiac arrest, Killip class IV (cardiogenic shock) at presentation and requiring a higher number of inotropes or vasopressors were independent predictive factors of in-hospital mortality.

Association of Dyslipidemia and Concomitant Risk Factors with In-Hospital Mortality in Acute Coronary Syndrome in Switzerland

Heart Drug ◽  
2005 ◽  
Vol 5 (3) ◽  
pp. 131-139 ◽  
Author(s):  
Dragana Radovanovic ◽  
Paul Erne ◽  
Julian Schilling ◽  
Giorgio Noseda ◽  
Felix Gutzwiller
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Coronary Syndrome

scholarly journals Risk Stratification and in Hospital Morality in Patients Presenting with Acute Coronary Syndrome (ACS) in Bahrain

2018 ◽  
Vol 12 (1) ◽  
pp. 7-17 ◽  
Author(s):  
Taysir S Garadah ◽  
Khalid Bin Thani ◽  
Leena Sulibech ◽  
Ahmed A Jaradat ◽  
Mohamed E Al Alawi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Systolic Hypertension ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Positive Serum ◽  
Grace Score

Background: Risk factors and short-term mortality in patients presented with Acute Coronary Syndrome (ACS) in Bahrain has not been evaluated before. Aim: In this prospective observational study, we aim to determine the clinical risk profiles of patients with ACS in Bahrain and describe the incidence, pattern of presentation and predictors of in-hospital clinical outcomes after admission. Methods: Patients with ACS were prospectively enrolled over a 12 month period. The rate of incidence of risk factors in patients was compared with 635 non-cardiac patient admissions that matched for age and gender. Multiple logistic regression analysis was used to predict poor outcomes in patients with ACS. The variables were ages >65 years, body mass index (BMI) >28 kg/m2, GRACE (Global Registry of Acute Coronary Events) score >170, history of diabetes mellitus (DM), systolic hypertension >180 mmHg, level of creatinine >160 μmol/l and Heart Rate (HR) on admission >90 bpm, serum troponin rise and ST segment elevation on the ECG. Results: Patients with ACS (n=635) were enrolled consecutively. Mean age was 61.3 ± 13.2 years, with 417 (65.6%) male. Mean age for patients with ST-segment elevation myocardial infarction (STEMI, n=156) compared with non-STEMI (NSTEMI, n=158) and unstable angina (UA, n=321) was 56.5± 12.8 vs 62.5±14.0 years respectively. In-hospital mortality was 5.1%, 3.1% and 2.5% for patients with STEMI, NSTEMI, and UA, respectively. In STEMI patients, thrombolytic therapy was performed in 88 (56.5%) patients and 68 (43.5%) had primary coronary angioplasty (PCI). The predictive value of different clinical variables for in-hospital mortality and cardiac events in the study were: 2.8 for GRACE score >170, 3.1 for DM, 2.2 for SBP >180 mmHg, 1.4 for age >65 years, 1.8 for BMI >28, 1.7 for creatinine >160 μmol/L, 2.1 for HR >90 bpm, 2.2 for positive serum troponin and 2.3 for ST elevation. Conclusion: Patients with STEMI compared with NSTEMI and UA were of younger age. There was higher in-hospital mortality in STEMI compared with NSTEMI and UA patients. The most significant predictors of death or cardiac events on admission in ACS were DM, GRACE Score >170, systolic hypertension >180 mmHg, positive serum troponin and HR >90 bpm.

scholarly journals Pattern and Prevalence of Dyslipidemia among Patients with Acute Coronary Syndrome Admitted in a Tertiary Level Hospital

2019 ◽  
Vol 34 (1) ◽  
pp. 31-36
Author(s):  
Dilshad Parvin ◽  
Sunil Krishna Baul ◽  
SM Rahat Hossain ◽  
Swati Munshi ◽  
Md Hadiuzzaman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Lipid Profile ◽  
Troponin I ◽  
Serum Levels ◽  
Modifiable Risk Factors ◽  
Coronary Syndrome ◽  
Control Subjects ◽  
Significant Difference ◽  
Artery Disease

Background: The leading cause of mortality in men and women worldwide is coronary artery disease (CAD). For hospitalization in our country, acute coronary syndrome (ACS) is a major reason. Dyslipidemia is found one of the most important modifiable risk factors for CAD. Aim: The aim of the study was to determine the pattern and prevalence of dyslipidemia among patients with ACS admitted in National Institute of Cardiovascular Diseases (NICVD), Dhaka. Subjects and methods: One thousand (1000) patients with ACS were included and classified according to clinical presentation, the findings on the admission electrocardiogram (ECG) and the results of serial cardiac troponin levels, into myocardial infarction(MI), either STelevation or non ST- elevation MI, and unstable angina(UA) subgroups. In the other group 500 healthy subjects were included as controls. All subjects were subjected determination lipid profile. ECG and Troponin- I were done for diagnosis and follow up of the patients. Results: In patients with ACS, high levels of TC (>200 mg/dl) were found in 60.67%,high levels of LDL (> 130 mg/dl) were found in 58%, high levels of TG (>150 mg/ dl) were found in 63.33%, however, low levels of HDL (< 40 mg/dl) were found in 66%. There was a statistically significant elevation in TC, LDL, TG serum levels in patients with ACS compared to control subjects (p<0.05) while the HDL was significantly low in ACS patient compared to control subjects (p <0.05). TC/HDL > 5 and TG/HDL> 4 were significantly higher in patients with ACS than controls. There was no significant difference between MI and UA patients regarding all lipid profile parameters. TC, LDL, TG were significantly higher in males than in females while HDL was significantly higher in females compared to males. Also TC/HDL and TG/HDL ratios were significantly higher in males compared to females. All lipid components were significantly more prevalent in males than in females except TG where there was no significant difference between males and females. Stepwise regression analysis of lipid parameters revealed that TC/HDL and TG/HDL ratios were independent risk factors for ACS. Conclusion: Dyslipidemia is one the major risk factors which is widely prevalent in patients with ACS and is more prevalent in males than in females. We recommend paying more attention to serum lipids and other modifiable risk factors for prevention of ACS and more studies about them as risk factors of atherosclerosis and its impact on other systems is advised. Bangladesh Heart Journal 2019; 34(1) : 31-36

Sex-related differences in characteristics, management and in-hospital outcome in sub-saharan patients with acute coronary syndrome

2018 ◽  
pp. 1-5
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Sex Differences ◽  
Time Delay ◽  
Troponin I ◽  
Density Lipoprotein ◽  
Coronary Syndrome ◽  
Anginal Pain ◽  
St Elevation ◽  
Sub Saharan

Background: Coronary heart disease remains the leading cause of morbidity and mortality in both men and women worldwide. Cardiovascular disease (CVD) is on the rise in sub-saharan countries that are currently undergoing rapid urbanization, industrialization, and lifestyle changes. Recently, knowledge regarding sex differences in CVD has evolved. Although, data on the incidence of acute coronary syndrome (ACS) in sub-saharan are not rare, few focused closely on sex differences. The purpose of this study was to examine sex-related differences in characteristics, management and inhospital outcome in sub-saharan with acute coronary syndrome. Methods: This was a retrospective study conducted at the cardiology department of Principal Hospital of Dakar over a period of 60 months (January 1st 2010 to December 31st 2014), in Dakar, Senegal. Two hundred and seven medical records of patients admitted for ACS based on anginal pain at rest, suggestive electrocardiographic changes and elevated troponin I levels, were included. We studied data on age, risk factors, symptoms, the time delay before admission, the management given, the vital parameters as as well as evolution during hospitalization. Medical records were then stratified into two categories (males and females) to study diferences. The studied parameters were entered into an electronic questionnaire using Epi Info version 3.3.5 of the World Health Organization. Results: Hospital prevalence of ACS was 6.09% with a sex ration M/F of 1.62(159/98). there was an overall rates increase of admissions for ACS in both men and women . The mean age of patients was 67.5 ± 10.1 years with a range of 44 and 93 years. Females were older than males ( p=0.08) with a greatest incidence of ACS in those aged 60 to 69 years. Women had a higher prevalence of risks, such as diabetes, hypertension, dyslipidemia, and obesity than men. In addition, there are sex differences in an order of importance related to risk factors for ACS. Hypertension, diabetes, and obesity are the most important risk factors in women, whereas current smoking, hypertension and diabetes are the important risk factors in men. Chest pain was present in 249 patients (97%). Typical anginal pain was more common in men than women (76.1% vs 52.1%), this difference was statistically significant (p=0.000). The average time delay before medical care was given was 29.09 ± 8.5 hours. This time delay was higher in women than men ( 53.9 ± 18 hours vs 26.4 ± 12.3 hours; p= 0.005) Mean troponin I level found was 1.9 ± 2.8 ng/ml, Creatine phosphokinase and Creatine phosphokinase-MB measured 824 ± 909.7 UI/l and 141.3 ± 245.9 UI/l respectively. Troponin I level was higher in men than women. Mean total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol and, triglyceride were 2.06 ± 0.25 g/l, 0.90 ± 0.2g/l, 0.90 ± 0.20 g/l, and 1.44 ± 0.20 g/l respectively. LDL cholesterol was higher in women than in men. Electrocardiogram revealed an ACS with persistent ST-elevation in 143 patients (90 males vs 53 females) and non ST-elevation ACS in 114 patients (69 males vs 45 females). Concerning treatment, thrombolysis using streptokinase was performed in 33 patients, accounting for 12.8% of patients with ST-elevation. Thrombolysis was performed in 10.2% of females compared to 14.5% of males (p=0.32). Six deaths (6.1%) were recorded in women and 10 (6.3% ) in men. Complications was dominated by pulmonary oedema. Conclusion: Our study confirms that acute coronary syndrome is not a “man’s only” disease in sub-sahara. Although in our study there was no difference in mortality, atypical presentation and low elevations in biomarker were responsible of long time delay before medical care in women.

scholarly journals Peran Estimasi Laju Filtrasi Glomerulus (eGFR) sebagai Prediktor Mortalitas pada Pasien Sindrom Koroner Akut selama Perawatan di ICCU

2017 ◽  
Vol 3 (4) ◽  
pp. 193
Author(s):  
Esthika Dewiasty ◽  
Idrus Alwi ◽  
Dharmeizar Dharmeizar ◽  
Kuntjoro Harimurti
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Medical Treatment ◽  
Renal Dysfunction ◽  
Control Group ◽  
Chi Square ◽  
Killip Class ◽  
Coronary Syndrome ◽  
Mortality Predictors

Pendahuluan. Pasien sindrom koroner akut (SKA) seringkali mengalami gangguan fungsi ginjal yang berhubungan dengan peningkatan risiko kematian SKA. Tatalaksana optimal dapat memperbaiki angka mortalitas, namun pasien dengan gangguan fungsi ginjal seringkali tidak mendapatkan tatalaksana optimal. Sampai saat ini belum ada studi yang meneliti hubungan antara gangguan fungsi ginjal dengan mortalitas selama perawatan di ICCU pada populasi di Indonesia yang berbeda dalam karakteristik klinis dengan populasi di luar negeri. Diperlukan penelitian mengenai hubungan antara gangguan fungsi ginjal dengan mortalitas selama perawatan di ICCU pada populasi Indonesia. Dengan demikian, diharapkan dapat dilakukan identifikasi dan stratifikasi pasien dengan risiko mortalitas tinggi sehingga dapat diberikan tatalaksana yang lebih optimal.Metode. Studi kasus kontrol dengan teknik sampling konsekutif dilakukan di Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada bulan Januari-Mei 2008 dengan sampel data rekam medik 300 pasien SKA yang dirawat di ICCU RSCM th 2003-2007. Sampel terdiri dari 100 pasien sindrom koroner akut yang mengalami kematian saat dirawat sebagai kasus dan 200 pasien yang tidak mengalami kematian sebagai kontrol. Analisis statistik menggunakan uji chi square untuk variabel bivariat dan analisis multivariat menggunakan regresi logistik untuk variabel-variabel perancu.Hasil. Didapakan hubungan yang bermakna antara penurunan fungsi ginjal (eGFR <60 ml/menit) dengan mortalitas (OR 2,97; IK 95% 1,726-5,106). Terdapat beberapa variabel lain yang bermakna sebagai prediktor mortalitas yaitu Killip Class (p <0,001), Luas Infark (p <0,001) dan terapi medikamentosa standar (p= 0,005). Pada analisis multivariat didapatkan adjusted OR untuk eGFR terhadap mortalitas sebesar 3,013 ( IK 95% 1,639-5,40)Simpulan. Estimasi Laju Filtrasi Glomerulus (eGFR) merupakan prediktor independen mortalitas pasien SKA selama perawatan di ICCU RSCM. Terdapat prediktor independen lain yang juga memengaruhi mortalitas yaitu Killip class, luas infark, dan terapi medikamentosa standar .Kata Kunci: eGFR, mortalitas, sindrom koroner akut Estimated Glomerular Filtration Rate (eGFR) as an In-Hospital Mortality Predictor in Acute Coronary Syndrome Patients in ICCUIntroduction. Due to the high in-hospital mortality rate of Acute Coronary Syndrome (ACS) patients, with renal dysfunction as one of its negative predictor, it is mandatory to screen renal dysfunction in ACS patients and investigate association between renal dysfunction and in-hospital mortality in ACS patients. To date, there is no such study which has been conducted in Indonesian population, which is different in clinical characteristics aspect with populations abroad. The aim of this study is to determine association between renal dysfunction (eGFR <60 ml/min) and in-hospital mortality in ACS patients who were hospitalized in ICCU Cipto Mangunkusumo Hospital. Methods. A case control study retrospectively was conducted. We investigated 100 ACS patients who were dead during hospitalization as the case group, and 200 ACS patients who were survived as the control group. The study was conducted in RSCM during January-May 2008. The subjects were ACS patients whom their medical records data were recorded since 2006 until 2007. We used consecutive sampling, We calculated the eGFR based on serum creatinine, age, and gender using formula of modified MDRD method for Chinese population. We calculated the odds ratios and the association with chi square test. Results. During the year 2006-2007, 100 ACS patients who were dead during hospitalization and 200 ACS patients who were survived were included in the study. We found significant association between renal dysfunction (eGFR <60 ml/min) and in-hospital mortality (OR 2,969 CI 95% 1,726-5,106). We also calculated other risk factors using multivariate analysis, and we had adjusted OR for eGFR was 3,013 (CI 95% 1,639-5,40). There were other risk factors which were significant as mortality predictors: Killip class (OR 4,046 CI 95% 2,235-7,322), large involvement area of infarct (OR 3,862 CI 95% 2,128-7,006), and non-standardized medical treatment (OR 2,598 CI 95% 1,238-5,452). Conclusions. Estimated GFR (eGFR) is an independent mortality predictor for in-hospital mortality in ACS patients. There are other risk factors which are significant as mortality predictors: Killip class, large involvement area of infarct, and non-standardized medical treatment. Keywords: acute coronary syndrome, eGFR, mortality

Prognostic Factors and Outcomes in Young Patients With Presented of Different Types Acute Coronary Syndrome

Angiology ◽  
2020 ◽  
Vol 71 (10) ◽  
pp. 894-902
Author(s):  
Sabiye Yılmaz ◽  
Kahraman Coşansu
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Young Patients ◽  
Hospital Death ◽  
Coronary Syndrome ◽  
Different Types ◽  
Long Term Mortality

The prevalence of coronary artery disease is increasing in young adults. We evaluated the outcomes of different types of acute coronary syndrome in 917 patients undergoing coronary angiography aged ≤45 years. Male sex, smoking, dyslipidemia were the most important risk factors. ST-elevation myocardial infarction (STEMI; 54.8%) predominated. The STEMI patients had higher risk of hospital mortality (3.6% vs 0.6%; P = .004) and major adverse cardiac and cerebrovascular events (MACCE; 13.8% vs 3.3%; P < .001, hazard ratio [HR], 4.65; 95% CI, 2.45-8.82). Presentation heart rate, blood pressure, heart failure, shock, arrhythmia, ejection fraction (EF), diabetes, contrast-induced nephropathy (CIN), and elevated troponin were associated with hospital mortality and MACCE. But only heart failure (HR, 5.816; 95% CI, 2.254-15.008) and CIN (HR, 6.241; 95% CI, 2.340-16.641) were independent risk factors for hospital MACCE. There was no difference in long-term mortality between the 2 groups, but non-STEMI patients had higher risk for MACCE after 3 years (14.4% vs 9.9%, P = .033). Although shock (HR, 0.814; 95% CI, 0.699-0.930), Killip class ≥2 (HR, 0.121; 95% CI, 0.071-0.170), CIN (HR, 0.323; 95% CI, 0.265-0.380), and EF (HR, 0.917; 95% CI, 0.854-0.984) were independent predictors of hospital death, only EF was the independent predictor of long-term mortality (HR, 0.897; 95% CI, 0.852-0.944).

scholarly journals LIS-3 Acute Coronary Syndrome Registry: Changes in Clinical and Demographic Characteristics and Tactics of Prehospital and Hospital Treatment of Surviving Patients After Acute Coronary Syndrome Over a 4-Year Period

2020 ◽  
Vol 16 (2) ◽  
pp. 266-272
Author(s):  
S. Yu. Martsevich ◽  
A. V. Zagrebelnyy ◽  
N. P. Zolotareva ◽  
N. P. Kutishenko ◽  
Yu. V. Lukina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Ace Inhibitors ◽  
Antiplatelet Agents ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Cardiology Department ◽  
St Segment ◽  
Frequency Of Use ◽  
History Of

Aim. To study the changes in clinical and demographic characteristics, risk factors, treatment tactics, the dynamics of drug therapy at the prehospital stage and prescribed during discharge from the cardiology department over a 4-year period in patients after acute coronary syndrome (ACS) with ST segment elevation and ACS without ST segment elevation. Material and methods. Data from the LIS-3 prospective registry (Lyubertsy mortality study) was used. Patients admitted to the cardiology department of the Lyubertsy district hospital No. 2 for the first 9 months of 2014 (n=104) and for the first 9 months of 2018 (n=223) with a diagnosis of “ACS with ST segment elevation and ACS without ST segment elevation” and with a confirmed diagnosis at discharge “acute myocardial infarction” (AMI) or “unstable angina” (NSA) were included into the study. Comparison of clinical and demographic indicators, risk factors, the frequency of use of acetylsalicylic acid, clopidogrel, statins, beta-blockers, ACE inhibitors, angiotensin II receptor antagonists, anticoagulants at the prehospital stage and during discharge from the hospital were performed. Results. Significant differences in the gender and age composition of patients were not found. The number of working patients increased. Compared to 2014, in 2018 the number of patients with arterial hypertension increased (64.4% and 75.8%, respectively, p=0.047), and with coronary heart disease decreased significantly (39.4% and 22.4%, respectively, p=0.004), however, the incidence of atrial fibrillation, history of AMI, and cerebral stroke did not change over the period under consideration. The frequency of concomitant diseases did not practically change, except for kidney diseases, which have become more common. A significant decrease in the frequency of thrombolysis and a significant (more than 6-fold) increase in angioplasty with stenting were found. Patients before ACS in 2014 received less antiplatelet agents than in 2018, including dual antiplatelet therapy, ACE inhibitors were prescribed more often. The intake of nitrates decreased, and the use of statins increased (6.7% versus 13.9%, respectively, p>0.05). AMI as the outcome of ACS was almost the same in both men and women. A downward trend in myocardial Q-infarction (p>0.05) was found. Taking dual antiplatelet therapy and ACE inhibitors were more often recommended at discharge and taking nitrates and any diuretics was less common. Statins intake did not change. Conclusion. The “portrait” of a hospitalized ACS patient changed somewhat over 4 years: the frequency of the history of coronary heart disease significantly decreased, and the frequency of hypertension increased. The presence and significance of risk factors such as hypercholesterolemia and adverse heredity cannot be assessed as before. The frequency of use of antiplatelet agents and statins increased in prehospital therapy; however, in general, a smaller proportion of patients requiring statins took them. The proportion of AMI patients among ACS ones did not change over the study period.

scholarly journals A Study of Risk Factors in Young Patients of Acute Coronary Syndrome

2020 ◽  
Vol 28 (1) ◽  
pp. 3-6
Author(s):  
Prodip Kumar Biswas ◽  
Md Hafiz Sardar ◽  
Gopal Chandra Saha ◽  
Mohammad Zaid Hossain ◽  
Mohammed Shahadat Hossain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Troponin I ◽  
Sedentary Lifestyle ◽  
Young Patients ◽  
Modifiable Risk Factor ◽  
Premature Coronary Artery Disease ◽  
Medical College ◽  
Coronary Syndrome

Aim: The study was carried out to see the risk factors of Acute Coronary Syndrome in young patients. Materials and Methods: This is a prospective study which was carried out in 60 young patients (18-40 years of age) with a diagnosis of Acute Coronary Syndrome admitted to Dhaka medical college Hospital, Dhaka. over a period of 02 years from January 2016 to January 2018. Acute Coronary Syndrome was diagnosed by clinical history, ECG evaluation and Serum Cardiac enzyme Troponin I and CK-MB estimation. Result: Most of the patients (73%) had a sedentary lifestyle and 50% had dyslipidemia. 40% patients were taking a diet rich in fats, 37% patients were diabetic, 33% were hypertensive, 37% patients consume oral tobacco, 30% were smokers, 13% were obese and 17% were alcoholics. The family history of premature coronary artery disease was present in only 13% of cases. In our study, none of the patients had consumed oral contraceptive pills. Conclusion: The most important modifiable risk factor is the sedentary lifestyle. The commonest non-modifiable risk factor is Male sex. Smoking, oral tobacco consumption, hypertension, diabetes, dyslipidemia, and diet modification are other important modifiable risk factors in young adults. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 3-6

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