scholarly journals Acute coronary syndrome (STEMI, NSTEMI and unstable angina pectoris) and risk factors, similarities and differences

2020 ◽  
Vol 51 (4) ◽  
pp. 252-260
Author(s):  
Dalibor Mihajlović ◽  
Žana Maksimović ◽  
Boris Dojčinović ◽  
Nada Banjac
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Unstable Angina ◽  
Early Recognition ◽  
Statistical Significance ◽  
Unstable Angina Pectoris ◽  
Cardiac Biomarkers ◽  
Coronary Syndrome ◽  
Banja Luka

Introduction: Acute coronary syndrome (ACS) is one of the m ost common and most dramatic manifestations of ischaemic h eart disease and distinguishing of ACS from non-cardiac chest pain represents a diagnostic challenge. Objective: Determine the frequency of ACS types: NSTEMI, STEMI and unstable angina pectoris (UAP) and examine the frequency and significance of risk factors and cardiospecific enzymes in patients with ACS. Methods: The analysis included patients who were referred from the prehospital level of the Banja Luka Primary Healthcare Centre (Emergency Department and Family Medicine Department) and treated under the ACS diagnosis in the coronary unit of the Cardiovascular Diseases Clinic of the Banja Luka University Clinical Centre of the Republic of Srpska (UCCRS) in the first 6 months of 2011. The study included patients older than 18, with recorded information on their gender, age, smoking status, hypertension, diabetes, obesity and family burden. Values of cholesterol, triglycerides, serum potassium, creatine kinase (CK), CK-MB, cardiac tro - ponin T (cTnT) were measured. Results: The total of 192 patients were referred under the referral diagnosis of ACS and treated in the coronary unit of the CVD Clinic of the Banja Luka UCCRS. At the same time, ACS was confirmed in 178 cases. STEMI was confirmed in 86 patients (48.31 %), NSTEMI in 55 (30.90 %) and UAP in 37 (20.79 %). ACS was statistically significantly more common in men (112 men and 66 women), in particular younger men (average age for men was 62.7 and 69.2 for men and women, respectively) (U = 2.472 x 103, p < 0.001). Among the risk factors, it was found th at smoking was more often associated with STEMI (p = 0.014) and hypertension with UAP (p = 0.041). Among all param eters, all three examined cardiac biomarkers showed statistical significance (p < 0.001), namely: values at STEMI > NSTEMI > UAP. Conclusion: Half of patients with ACS did not have STEMI (which is presumably easy to diagnose). Third of patients with ACS reported atypical symptoms, which further complicates the early recognition of MI without ST elevation. Precaution is needed in women and in elderly. Determination of cTnT should be available in every examination room.

scholarly journals Elevated Plasma IL-37, IL-18, and IL-18BP Concentrations in Patients with Acute Coronary Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Qingwei Ji ◽  
Qiutang Zeng ◽  
Ying Huang ◽  
Ying Shi ◽  
Yingzhong Lin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Unstable Angina ◽  
Left Ventricular ◽  
Unstable Angina Pectoris ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Objective.More recently, evidence showed that the novel anti-inflammatory cytokine interleukin- (IL-) 37 was expressed in the foam-like cells of atherosclerotic coronary and carotid artery plaques, suggesting that IL-37 is involved in atherosclerosis-related diseases. However, the plasma levels of IL-37 in patients with acute coronary syndrome (ACS, including unstable angina pectoris and acute myocardial infarction) have yet to be investigated.Methods.Plasma IL-37, IL-18, and IL-18BP levels were measured in 50 patients with stable angina pectoris (SAP), 75 patients with unstable angina pectoris (UAP), 67 patients with acute myocardial infarction (AMI), and 65 control patients.Results.The plasma IL-37, IL-18, and IL-18BP levels were significantly increased in ACS patients compared to SAP and control patients. A correlation analysis showed that the plasma biomarker levels were positively correlated with each other and with the levels of C-reactive protein (CRP),N-terminal probrain natriuretic peptide (NT-proBNP), and left ventricular end-diastolic dimension (LVEDD) but negatively correlated with left ventricular ejection fraction (LVEF). Furthermore, the plasma IL-37, IL-18, and IL-18BP had no correlation with the severity of the coronary artery stenosis.Conclusions.The results indicate that the plasma IL-37 levels are associated with the onset of ACS.

scholarly journals Immature Platelet Fraction (IPF) Levels in Acute Coronary Syndrome (ACS) Patients

2021 ◽  
Vol 8 (8) ◽  
pp. 682-688
Author(s):  
Enna Berkah Sari ◽  
Nizam Zikri Akbar ◽  
Herman Hariman
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Unstable Angina ◽  
Unstable Angina Pectoris ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Immature Platelet Fraction

Background: Acute Coronary Syndrome (ACS) is a major cardiovascular problem because it causes high hospital admissions and mortality rates. Acute Coronary Syndrome is divided into 3 (three), namely: unstable angina pectoris (UAP), myocardial infarction without ST segment elevation (NSTEMI), and myocardial infarction with ST segment elevation (STEMI). In addition to changes in biomarkers of heart injury, the platelet index (IPF = immature platelet fraction) will also change the level difference between STEMI with NSTEMI/UAP. Objective: To determine the differences in IPF levels of ACS patients with STEMI and NSTEMI/UAP Method: Observational analytic with cross sectional approach. The subjects of this study were 80 patients who came to the emergency installation of integrated heart center Emergency Room Haji Adam Malik Hospital Medan from May 2019 to September 2019 and was diagnosed with ACS (STEMI or NSTEMI/UAP). The sample in the study was the patient's venous blood and put it in an EDTA tube, then immediately checked the IPF value/level using the automatic hematology analyzer. Patients with heart failure or patients with thrombocytopenia were not included in this study. Results: In this study, the demographic characteristics of the ACS patients based on gender were male 77.5% STEMI and 87.5% NSTEMI/UAP while women 22.5% STEMI and 12.5% ​​NSTEMI/UAP. The results of the STEMI patient's IPF levels Compared with NSTEMI/UAP, the median is 6.2 (3.5-16.8) VS 2.9 (0.7-12) with a p-value of 0.0001. Conclusion: The characteristics of ACS patients based on the results of sex were that there were more men with NSTEMI/UAP than those with STEMI. There was a significant difference in the IPF levels of STEMI with NSTEMI/UAP. Keywords: Immature Platelet Fraction (IPF), Acute Coronary Syndrome (ACS), ST-Segment Elevation Myocardial Infarction (STEMI), Non ST-Segment Elevation Myocardial Infarction (NSTEMI), Unstable Angina Pectoris (UAP).

scholarly journals PREVALENSI SINDROM KORONER AKUT DI RSUP PROF. DR. R. D. KANDOU MANADO PERIODE 1 JANUARI 2014 - 31 DESEMBER 2014

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Biancha Tumade ◽  
Edmond L. Jim ◽  
Victor F. F. Joseph
Keyword(s):  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Unstable Angina ◽  
Myocardial Infarct ◽  
Total Sample ◽  
Unstable Angina Pectoris ◽  
Acute Myocardial Infarct ◽  
Coronary Syndrome ◽  
Brain Center ◽  
St Elevation

Abstract: Acute Coronary Syndrome (ACS) is a syndrome that occurred due to pathological changes inside the coronary artery wall which cause myocardial ischemic, Unstable Angina Pectoris (UAP), and Acute Myocardial Infarct (AMI) such as Non ST Elevation Myocardial Infarct (NSTEMI) and ST Elevation Myocardial Infarct. The prevalence of coronary heart disease (CHD) in Indonesia is 0.5% from the total sample of non-communicable diseases and from the total sample diagnosed with CHD the highest is in Middle Sulawesi (0.8%) followed by North Sulawesi (0.7%). This study aimed to obtain the prevalence of ACS in Prof. Dr. R. D. Kandou Hospital from 1 January to 31 December 2014. This was a descriptive retrospective study. Data were obtained from the medical record and Cardiovascular and Brain Center (CVBC) of Prof. Dr. R. D. Kandou Hospital in Manado. The results showed that there were 126 cases of ACS, 72 cases (57.1%) of UAP, 35 cases (37.8%) of NSTEMI, and 19 cases (15.1%) of STEMI. From the 126 cases there were 90 males (71.4%) and 36 females (28.6%). Based on age there were 2 cases (1.6%) of 31-40 years old, 15 cases (11.9%) of 41-50 years old, 42 cases (33.3%) of 51-60 years old, 48 cases (38.1%) of 61-70 years old,  16 cases (12.7%) of 71-80 years old, and 3 cases (2.4%) of over 80 years old. Based on histories of ACS assisted diseases, there were 87 (69.0%) cases of hypertension, 32 cases (25.4%) of diabetes mellitus, 37 cases (29.4%) of dyslipidemia, 7 cases (5.6%) of obesity, 19 cases (15.1%) of smokers, and 122 cases (96.8%) of ACS patients had more than one risk factor. Conclusion: In this study, the most prevalence of ACS was UAP, males, aged 61-70 years, and had hypertension history. Keywords: acute coronary syndrome, prevalence   Abstrak: Sindrom Koroner Akut (SKA) merupakan keadaan terjadinya perubahan patologis dalam dinding arteri koroner, sehingga menyebabkan iskemik miokardium dan menimbulkan Unstable Angina Pectoris (UAP) serta Infark Miokard Akut (IMA) seperti Non ST Elevation Myocardial Infarct (NSTEMI) dan ST Elevation Myocardial Infarct (STEMI). Di Indonesia prevalensi penyakit jantung koroner (PJK) sebesar 0,5% dari total sampel penyakit tidak menular dan tertinggi di Sulawesi Tengah sebanyak 0,8% diikuti Sulawesi Utara 0,7% dari total pasien terdiagnosis PJK. Penelitian ini bertujuan untuk mengetahui prevalensi penderita SKA yang dirawat di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2014 sampai 31 Desember 2014. Penelitian ini merupakan studi deskriptif retrospektif dengan menggunakan data Bagian Rekam Medik dan Cardivascular and Brain Center (CVBC) RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian memperlihatkan 126 kasus SKA, kasus UAP sebanyak 72 kasus (57,1%), NSTEMI 35 kasus (37,8%), dan STEMI 19 kasus (15,1%). Laki-laki sebanyak 90 kasus (71,4%) dan perempuan 36 kasus (28,6%). Kelompok umur 31-40 tahun sebanyak 2 kasus (1,6%), 41-50 tahun 15 kasus (11,9%), 51-60 tahun 42 kasus (33,3%), 61-70 tahun 48 kasus  (38,1%), 71-80 tahun 16 kasus (12,7%), dan >80 tahun 3 kasus (2,4%). Riwayat hipertensi sebanyak 87 kasus (69,0%), diabetes melitus 32 kasus (25,4%), dislipidemia 37 kasus (29,4%), obesitas 7 kasus (5,6%), dan merokok 19 kasus (15,1%). Simpulan: Prevalensi kasus SKA terbanyak adalah kasus UAP, berjenis kelamin laki-laki, berumur 61-70 tahun, serta memiliki riwayat hipertensi.Kata kunci: sindrom koroner akut, prevalensi

Estimating the incidence of the acute coronary syndrome: data from a Danish cohort of 138290 persons

2007 ◽  
Vol 14 (5) ◽  
pp. 608-614 ◽  
Author(s):  
Kirsten M. Nielsen ◽  
Anders Foldspang ◽  
Mogens L. Larsen ◽  
Lars U. Gerdes ◽  
Soeren Rasmussen ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Unstable Angina ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Unstable Angina Pectoris ◽  
Administrative Databases ◽  
Crude Incidence ◽  
Coronary Syndrome ◽  
The Individual

Background Estimates of incidence are crucial to the planning of public health measures, but most studies of incidence of, for example, acute myocardial infarction (MI) are troubled by methodological problems such as; (i) selection biases of the patients being included for study, (ii) lack of identification and control of the cohort under observation, (iii) inconsistencies in the use of diagnostic criteria, and (iv) missing data. We aimed to measure directly the incidence of the entire spectrum of the acute coronary syndrome (ACS), consisting of unstable angina pectoris, MI and sudden cardiac death (SCD), by use of the new criteria for MI as proposed in 2000. Design Cohort study. Methods From a cohort of 138 290 residents of the municipality of Aarhus, Denmark, aged 30-69 years, with a demographic structure known at the individual population member level, we prospectively identified all consecutive ACS patients from 1 April 2000 to 31 March 2002. The population was identified from Danish Population Registers. Results A total of 189 victims of SCD and 457 ACS patients who survived until admission to hospital were present. Consequently, crude incidence rate of ACS was 234 per 100000 person-years. Unstable angina pectoris constituted for 16.9%, MI for 53.8% and SCD for 29.3% of ACS patients. Conclusions Crude incidence rates of ACS were 137 and 331 per 100 000 person years for women and men, respectively. The incidence rate of ACS, as measured directly, was insignificantly 6% higher than expected from Danish administrative databases. Eur J Cardiovasc Prev Rehabil 14:608-614 © 2007 The European Society of Cardiology

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

An Overview and Awareness of Acute Coronary Syndrome Based on Risk Factors, Early Clinical Assessment Tools, and Improving Clinical Outcomes

2019 ◽  
Vol 12 (1) ◽  
pp. 125-131
Author(s):  
Eulalia D'souza
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Clinical Outcomes ◽  
Cause Of Death ◽  
Clinical Assessment ◽  
The United States ◽  
Assessment Tools ◽  
Cardiac Biomarkers ◽  
Timely Manner ◽  
Coronary Syndrome

BackgroundCardiovascular disease is the leading cause of death worldwide accounting for 17.3 million deaths per year, a number that is estimated to grow to more than 23.6 million by 2030. Coronary artery disease (CAD) is the most common form of cardiovascular diseases and remains the number one cause of death in the United States, killing more than 375,000 Americans every year. Acute coronary syndrome (ACS) is a manifestation of CAD, which is life threatening and an emergency situation.ObjectiveTo provide an overview and an awareness of ACS based on risk factors, early clinical assessment tools, and to improving clinical outcomes.MethodsFor registered nurses (RNs) in any clinical setting, this overview will educate and inform nurses how they can approach patient care in an urgent and timely manner.ResultsAdvances in diagnostic cardiac biomarkers, risk assessment tools, medical management, and invasive strategies have allowed for earlier and more accurate diagnosis and treatment of ACS, thereby improving clinical outcomes.ConclusionsCompetence in early recognition of the major differences in clinical presentation of ACS will enable prompt diagnosis and initiation of proven therapies.Implications for Nursing PracticeAs the prevalence for ACS continues to rise, RNs in all clinical settings should make a concerted effort to identify and mitigate risk factors early as well as to recognize, diagnose, and respond to ACS events in a timely manner.

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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