scholarly journals IMPACT OF CERTAIN PUBLIC HEALTH FACTORS ON THE DURATION OF INPATIENT TREATMENT OF MI PATIENTS

2020 ◽  
Vol 73 (5) ◽  
pp. 850-856
Author(s):  
Natalia O. Terenda ◽  
Arkadii H. Shulhai ◽  
Yurii M. Petrashyk ◽  
Olha N. Lytvynova ◽  
Natalia Y. Panchyshyn ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Inpatient Treatment ◽  
Treatment Duration ◽  
Cox Regression ◽  
Treatment Method ◽  
Hospital Treatment ◽  
Coronary Artery Stenting ◽  
Medical Effectiveness ◽  
The Impact

The aim was to study the impact of predictors on the duration of inpatient treatment of MI patients. Materials and methods: We copied data of 462 inpatient medical records of myocardial infarction patients who underwent hospital treatment by different methods (coronary artery stenting, thrombolytic therapy, conventional drug therapy). We determined basic predictors and duration of inpatient treatment of MI patients. Impact of the parameters was studied using Cox regression. Results: We built models of hazard ratios of coronary artery stenting impact on treatment duration for myocardial infarction patients, which proved that this treatment method significantly reduced the treatment duration, even after correction of confounders like sex (HR=1.32; p=0.041), age over 60 (HR=1.31; p=0.048) and heart failure Stage 2A-2B (HR=1.36; p=0.020). Conclusions: The results we obtained indicate a statistically significant effect of CAS on MI patients’ treatment duration, both separately and combined with multiple effects of confounders, indicating its medical effectiveness and the need for widespread introduction of this treatment method in medical practice in every region of Ukraine.

scholarly journals A Study on the Relationship between Iron Reserves and the Intensity of Coronary Artery Stenosisin Angiography Candidates

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Khalil Mahmoodi
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Transferrin Saturation ◽  
Intervention Group ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Coronary Artery Stenos ◽  
The Impact ◽  
The Relationship

Various risk factors including blood iron may create coronary artery diseases and lead to myocardial infarction. There are controversies with regard to the impact of blood iron on myocardial infarction. Therefore, the aim of this paper was to investigate the relationship between iron reserves and the intensity of coronary artery stenos is among angiographic candidates in Zanjan, Iran. This was a cross sectional study. Samples were consisted of patients who were hospitalized for diagnostic coronary angiography in hospitals in an urban area of Iran. A convenient sampling method was used to recruit samples via interviews and laboratory examinations for FBS, iron, TIBC, ferritin, creatinine serum, CBC, cholesterol, HDL and LDL. The samples were divided into control and intervention groups. After coronary angiography, the intervention group was evaluated by four different methods including the extent score, stenos is score, vessel score and Duke CAN Index. The samples were consisted of 89 men (60.1%) and 59 women (39.9%). The levels of ferritin (p=0.003) and iron (p=0.002), and transferrin saturation percent (p=0.002) showed significant differences between males and females (p=0.004)

Abstract 13993: Impact of Prasugrel Pretreatment and Timing of Coronary Artery Bypass Grafting on Clinical Outcomes of Patients With Non-ST-Segment Elevation Myocardial Infarction: From the Accoast Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Dariusz Dudek ◽  
Petr Widimsky ◽  
Leonardo Bolognese ◽  
Patrick Goldstein ◽  
Christian Hamm ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Cabg Patients ◽  
The Impact

Objectives: We evaluated the impact of prasugrel pretreatment and timing of coronary artery bypass grafting (CABG) on clinical outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing CABG based on data from ACCOAST. Methods: We evaluated the impact of troponin, prasugrel pretreatment and CABG timing on clinical outcomes of NSTEMI patients undergoing CABG through 30 days from ACCOAST. Results: CABG patients versus PCI or medically managed patients were more often male, diabetic, had peripheral arterial disease and a higher GRACE score. By randomization assignment, 157 patients received a 30-mg loading-dose of prasugrel before CABG; 157 patients did not. CABG patients were grouped by tertiles of time from randomization to CABG; baseline characteristics in the Table. Patients in the lowest tertile had significantly more events (cardiovascular death, MI, stroke, urgent revascularization or glycoprotein IIb/IIIa bailout) and all TIMI major bleeds than those in the other 2 groups (p<0.045, p<0.002 respectively), but the patients in the higher 2 groups were not significantly different from each other. No difference was detected in all cause death among the 3 groups (p>0.39). A multivariate model evaluated 5 possible predictors of the composite endpoint of all cause death, MI, stroke and TIMI major bleeding. Time from randomization to CABG (HR 0.84 for each 1 hour of delay), left main disease presence (HR 1.76), and region of enrollment (Eastern Europe vs other, HR 3.83) were significant predictors but not prasugrel pretreatment or baseline troponin level ≥3xULN. Conclusions: In this group of high-risk patients presenting with NSTEMI, early surgical revascularization carried an increased risk of bleeding and ischemic complications, without impact on all-cause mortality. No impact of baseline troponin or prasugrel pretreatment (important factors influencing time of CABG) on clinical outcomes was confirmed.

Abstract 18682: Inflammatory Biomarkers for Prognostication of Outcomes in Stable Coronary Artery Disease - Experiences From the STABILITY Trial

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Claes Held ◽  
Harvey D White ◽  
Ralph A Stewart ◽  
Andrzej Budaj ◽  
Christopher P Cannon ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medical Treatment ◽  
Cox Regression ◽  
Stable Coronary Artery Disease ◽  
Cardiac Biomarkers ◽  
Prognostic Information ◽  
Hs Crp ◽  
Artery Disease ◽  
The Impact

Introduction: Prognostication of outcome in patients with stable coronary artery disease (CAD) is currently based on clinical characteristics and biomarkers indicating dysglycemia, dyslipidemia, renal dysfunction and possibly cardiac biomarkers. Hypothesis: We assessed the incremental prognostic value of biomarkers of inflammation in the Stabilization of Atherosclerotic Plaque By Initiation of Darapladib Therapy (STABILITY) trial. Methods: In STABILITY, 15,828 patients with chronic CAD on optimal medical treatment were randomized to treatment with darapladib or placebo. Serum levels of hs-C-reactive protein (CRP) and Interleukin (IL)-6 were measured at randomization in 14,373 and 4733 patients, respectively. Centrally adjudicated outcome events were accumulated during a median of 3.7 years follow-up. The associations between levels of the biomarkers and outcomes were evaluated by multivariable Cox regression. Results: The impact of biomarker levels at baseline in relation to the composite endpoint, MACE (major adverse cardiovascular event), of cardiovascular (CV) death, myocardial infarction (MI) and stroke, and its individual components are presented in the Table. Both hs-CRP and IL-6 provided strong prognostic information in addition to clinical predictors for outcomes of MACE, CV death and MI, but not for stroke. Conclusions: In conclusion, the cardiac biomarkers hs-CRP and IL-6, provided important complementary prognostic information on the risk of CV mortality and MI, but not for stroke in patients with stable CAD on optimal medical treatment.

Myocardial reperfusion reverses the J-curve association of cardiovascular risk and diastolic blood pressure in patients with left ventricular dysfunction and heart failure after myocardial infarction: insights from the EPHESUS trial

2020 ◽  
Vol 41 (17) ◽  
pp. 1673-1683 ◽  
Author(s):  
Michael Böhm ◽  
João Pedro Ferreira ◽  
Felix Mahfoud ◽  
Kevin Duarte ◽  
Bertram Pitt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Cox Regression ◽  
Cardiovascular Death ◽  
Left Ventricular ◽  
Coronary Perfusion ◽  
Increased Risk ◽  
The Impact

Abstract Aims The described association of low diastolic blood pressure (DBP) with increased cardiovascular outcomes could be due to reduced coronary perfusion or is simply due to reverse causation. If DBP is physiologically relevant, coronary reperfusion after myocardial infarction (MI) might influence DBP–risk association. Methods and results The relation of achieved DBP with cardiovascular death or cardiovascular hospitalization, cardiovascular death, and all-cause death was explored in 5929 patients after acute myocardial infarction (AMI) with impaired left ventricular function, signs and symptoms of heart failure, or diabetes in the EPHESUS trial according to their reperfusion status. Cox regression models were used to assess the impact of reperfusion status on the association of DBP and systolic blood pressure (SBP) with outcomes in an adjusted fashion. In patients without reperfusion, lower DBP &lt;70 mmHg was associated with increased risk for all-cause death [adjusted hazard ratios (HRs) 1.80, 95% confidence interval (CI) 1.41–2.30; P &lt; 0.001], cardiovascular death (HR 1.70, 95% CI 1.3–3.22; P &lt; 0.001), cardiovascular death or cardiovascular hospitalization (HR 1.54, 95% CI 1.26–1.87; P &lt; 0.001). In patients with reperfusion, the risk increase at low DBP was not observed. At low SBP, risk increased independently of reperfusion. A sensitivity analysis in the subgroup of patients with optimal SBP of 120–130 mmHg showed again risk reduction of reperfusion at low DBP. Adding the treatment allocation to eplerenone or placebo into the models had no effects on the results. Conclusion Patients after AMIs with a low DBP had an increased risk, which was sensitive to reperfusion therapy. Low blood pressure after MI identifies in patients with particular higher risk. These data support the hypothesis that low DBP in patients with stenotic coronary lesions is associated with risk, potentially involving coronary perfusion pressure and the recommendations provided by guidelines suggesting lower DBP boundaries for these high-risk patients.

Alcohol-related absence from work and hospital treatment are associated with higher mortality and permanent disability among workers

2011 ◽  
Vol 26 (S2) ◽  
pp. 125-125
Author(s):  
F. Wedegaertner ◽  
S. Arnhold-Kerri ◽  
N.-A. Sittaro ◽  
T. Hillemacher ◽  
S. Bleich ◽  
...  
Keyword(s):  
Alcohol Abuse ◽  
Inpatient Treatment ◽  
Early Retirement ◽  
Cox Regression ◽  
Psychiatric Treatment ◽  
Premature Death ◽  
Hospital Treatment ◽  
Permanent Disability ◽  
Related Absenteeism

AimsIt was the aim of this study to estimate effects of alcohol abuse on early retirement and premature death in the working population with special emphasis on alcohol related absenteeism from work and inpatient treatment.MethodsSample consisted of 125.019 resp. 128.001 health insurance clients up to age 58 resp. 74 were used. Mean follow-up period was 6.4 years. Excess risks were calculated with Cox regression models adjusted for age, gender, education and job classification.ResultsBoth alcohol-related absenteeism from work (without inpatient treatment) and detoxification treatment were associated with higher risks of early retirement (RR 2.59, CI 2.21–3.04, p < 0.001; RR 2.29, CI 1.99–2.62, p < 0.001) and premature death (RR 3.26 CI 2.74–3.88, p < 0.001; RR 4.41, CI 3.90–4.98, p < 0.001).Further analysis showed higher risks of early retirement for males. Females who sought inpatient treatment for alcohol abuse/addiction had the highest risk of premature death (RR 7.75, CI 5.61–10.68, p < 0.001). Marked increases of the risks for permanent disablity and death during the follow-up period could also be oberserved after all-cause inpatient treatment in patients with a comorbid alcohol problem.ConclusionsThe detrimental effect of alcoholism on life expectancy and capacity to work is considerable after absenteeism from work, psychiatric treatment and all-cause inpatient treatment. While female patients in detoxification wards are a minority, they may be more strongly affected by the somatic complications of alcohol abuse. Nevertheless, strong selection biases in this subsample need to be considered and the data interpreted with caution.

Abstract P85: Are Myocardial Bridges Associated With Increased Risk of Death or Myocardial Infarction?

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Mouaz H Al-Mallah ◽  
Kamal Kassem ◽  
Owais Khawaja ◽  
Thomas Song ◽  
Chad Poopat ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Cox Regression ◽  
Study Cohort ◽  
Risk Of Death ◽  
Increased Risk ◽  
Artery Disease

Background: Myocardial bridging (MB) is frequently seen on coronary CT angiography (CCTA). However, there has been conflicting data on the prognostic value of MB. The aim of this analysis is to determine the prognostic value of MB in patients without obstructive coronary artery disease (CAD) (<50 diameter stenosis). Methods: We included patients with no known prior coronary artery disease (CAD) who underwent CCTA for various clincial reasons. Patients with obstructive CAD on CCTA were excluded. The study cohort was followed for all cause mortality or myocardial infarction (MI) (median follow-up 1.7 years). Group comparisons were made between patients with patients with or without MB. Results: A total of 715 patients were included in this analysis of which 68 patients had MB (10%). 73% of the bridges were in the mid LAD and 22% had bridging in the distal LAD. 48% of the study cohort had normal coronaries, while 52% had evidence of non obstructive CAD. There were no differences in the baseline characteristics, symptomatic status or prevalence of non obstructive CAD between the two groups (all p>0.5). After a median follow-up duration of 1.7 years, 23 patients died and 10 patients experienced myocardial infarction. There were no statistically significant differences in the rate of death/MI between the two groups (figure). Using multivariable Cox regression, the presence of MB was not associated with increased risk for death/MI (Adjusted HR 0.4, 95% confidence interval 0.1 -2.8, p=0.34) Conclusions: In patients with non-obstructive CAD, MB is not associated with increased risk for all cause death or MI.

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