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Vucic, Rada, Slavko Knezevic, Zorica Lazic, Olivera Andrejic, Dragan Dincic, Violeta Iric-Cupic, and Vladimir Zdravkovic. "Elevation of troponin values in differential diagnosis of chest pain in view of pulmonary thromboembolism." Vojnosanitetski pregled 69, no. 10 (2012): 913–16. http://dx.doi.org/10.2298/vsp1210913v.
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Introduction. Acute coronary syndrome, as unstable form of ischaemic heart disease, beside clinical presentation and electrocardiographic abnormalities, is characterized by increased value of troponin one of cardiospecific enzimes. Although troponin is a high specific and sensitive indicator of acute coronary syndrome, any heart muscle injury may induce its increasing, so there are some other diseases with the increased troponin value. Case report. We presented a female patient with chest pain, admitted because of suspicioun of acute coronary sindrome. Performed coronarography excluded ischemic heart disease. Considering symtomatology, electrocardiographic abnormalities, increased troponin and D-dimer values, as well as echocardiography finding we considered pulmonary embolism as a differential diagnosis, which was confirmed by pulmoangiography. Conclusion. Isolated increased troponin values are not enough for diagnosis of acute coronary syndrome.
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Biasucci, Luigi M., Margherita Marcantoni, Maria Teresa Cardillo, Gina Biasillo, annalisa caroli, Giovanni Luigi De Maria, Ilaria Dato, Massimo Gustapane, Luca Di Vito, and Filippo Crea. "GENE EXPRESSION PROFILING IN CIRCULATING MICROPARTICLES OF PATIENTS WITH ACUTE CORONARY SINDROME." Journal of the American College of Cardiology 59, no. 13 (March 2012): E494. http://dx.doi.org/10.1016/s0735-1097(12)60495-1.
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Sladojevic, M., S. Sladojevic, S. Tadic, and M. Stefanovic. "[PP.04.26] IN-HOSPITAL OUTCOME PREDICTIONS FOR ACUTE CORONARY SINDROME PATIENTS AFTER CORONRY ANGIOPLASTY BY MINING ECHOCARDIOGRAPHY PARAMETERS DATA." Journal of Hypertension 35 (September 2017): e118. http://dx.doi.org/10.1097/01.hjh.0000523296.71335.e2.
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Kostić, Tomislav, Zoran Perišić, Svetlana Apostolović, Mihajlo Lazarević, Dragana Stanojević, and Ivana Miljković. "Antiplatelet therapy in acute coronary syndrome." Galenika Medical Journal 1, no. 3 (2022): 77–83. http://dx.doi.org/10.5937/galmed2203071k.
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Unstable angina and myocardial infarction, without or with ST elevation, are entities of acute coronary syndrome (ACS). Main pathophysiologic mechanism of ACS is rupture of atherosclerotic plaque leading to thrombus formation in coronary arteries. Different groups of medications are given for treatment of this life-threatening condition. Acetylsalicylic acid is base of therapy and choice of other medications depends on risk factors for thrombosis and bleeding, comorbidities and the ability to transfer patient to the center where coronary stent can be implanted.
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Vivas, D., J. C. Garcia-Rubira, E. Bernardo, D. J. Angiolillo, P. Martin, A. Calle-Pascual, I. Nunez-Gil, C. Macaya, and A. Fernandez-Ortiz. "Effects of intensive glucose control on platelet reactivity in patients with acute coronary syndromes. Results of the CHIPS Study ("Control de Hiperglucemia y Actividad Plaquetaria en Pacientes con Sindrome Coronario Agudo")." Heart 97, no. 10 (March 4, 2011): 803–9. http://dx.doi.org/10.1136/hrt.2010.219949.
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Karo, Irma Ersalina Br, Ida Bagus Rangga Wibhuti, and I. Nyoman Wiryawan. "Kadar low density lipoprotein (LDL) tinggi berhubungan dengan peningkatan severitas sindrom koroner akut." Intisari Sains Medis 11, no. 3 (December 1, 2020): 1174–77. http://dx.doi.org/10.15562/ism.v11i3.658.
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Background: Acute coronary syndrome (ACS) is a collection of symptoms that caused by disruption of coronary arteries so that decreasing the oxygen levels to the heart muscle (myocardium). Low-density Lipoprotein (LDL) is a lipid-carrying lipoprotein with the strongest predisposing factor compared to other cholesterol in supporting the formation of atheroma plaques in blood vessels that flow through the heart muscle in patients with acute coronary syndrome.Methods: This study is an analytic cross-sectional observational study aimed at seeing whether there is a relationship between levels of Low Density Lipoprotein (LDL) with an increase in severity of acute coronary syndrome. The population of this study were patients with a diagnosis of acute coronary syndrome at Sanglah Hospital Denpasar from July 2018 – January 2019. The relationship between LDL levels and severity of acute coronary syndrome was analyzed using Spearman correlation test and multivariate analysis in the form of discriminant analysis to analyze the relationship of LDL levels with severity of acute coronary syndrome compared with other risk factors as confounding variables.Results: Spearman correlation test showed that there was a significant positive relationship between LDL levels and severity of acute coronary syndrome with p = 0.01 and Spearman’s correlation coefficient of +0.365. The result of the study of discriminant analysis test also showed that there was a significant positive relationship between LDL levels and severity of acute coronary syndrome after being analyzed along with confounding variables with a value of p = 0.004.Conclusions: There was a significant positive relationship between LDL levels and severity of acute coronary syndrome at RSUP Sanglah Latar Belakang: Sindrom koroner akut merupakan suatu sekumpulan gejala yang disebabkan adanya gangguan pada arteri koronaria sehingga kadar oksigen menuju otot jantung (miokardium) mengalami penurunan. Low-Density Lipoprotein (LDL) merupakan lipoprotein pengangkut lipid dengan faktor predisposisi terkuat dibandingkan kolesterol lain dalam mendukung pembentukan plak ateroma pada pembuluh darah yang mengaliri otot jantung pada penderita sindrom koroner akut. Metode: Penelitian ini bersifat observasional cross-sectional analitik yang bertujuan untuk melihat apakah terdapat hubungan antara kadar Low Density Lipoprotein (LDL) dengan peningkatan severitas sindrom koroner akut. Populasi dari penelitian ini merupakan pasien dengan diagnosis sindrom koroner akut di RSUP Sanglah Denpasar pada Juli 2018 – Januari 2019. Hubungan antara kadar LDL dengan severitas sindrom koroner akut dianalisis menggunakan uji korelasi Spearman serta analisis multivariat berupa uji analisis diskriminan untuk menganalisis hubungan kadar LDL dengan severitas sindrom koroner akut dibandingkan dengan faktor resiko lain sebagai variabel perancu.Hasil: uji korelasi Spearman menunjukkan terdapat hubungan positif bermakna antara kadar LDL dengan severitas sindrom koroner akut dengan nilai p = 0.01 serta koefisien korelasi Spearman sebesar +0,365. Hasil penelitian pada uji analisis diskriminan juga menunjukkan terdapat hubungan positif bermakna antara kadar LDL dengan severitas sindrom koroner akut setelah dianalisis bersama variabel perancu, dengan nilai p = 0,004.Simpulan: Terdapat hubungan yang positif yang bermakna antara kadar LDL dan severitas sindrom koroner akut pada pasien sindrom koroner akut di RSUP Sanglah
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Drăgan, Eleonora, Maria Suzana Guberna, Cătălina Liliana Andrei, and Crina-Julieta Sinescu. "THYROID DYSFUNCTION IN THE PATIENT WITH ACUTE CORONARY SYNDROME." Romanian Medical Journal 68, no. 2 (June 30, 2021): 248–55. http://dx.doi.org/10.37897/rmj.2021.2.18.
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Purpose. The study aims to determine the impact of dystyroidism on the type of acute coronary syndrome, on vascular function and coronary impairment, as well as on the myocardium and last but not least the general biological resonance of these hormones, emphasizing the role of thyroid hormones in the cardiovascular system. Methods. We introduced in the study 100 patients recently diagnosed with acute coronary syndrome, without history of ischemic heart disease or thyroid disease, hospitalized in the Cardiology Clinic of the Emergency Clinical Hospital Bagdasar-Arseni Bucharest, for the interventional treatment of acute coronary syndrome. The studied patients were hospitalized between November 2014 - April 2015, with follow-up up to 5 years, evaluated clinically, bio-humorally, by echocardiography, coronary angiography with SYNTAX score calculation and electrocardiogram and pulse wave. The obtained data were integrated in Excel sheets and statistically processed with the Python program. Results. The prevalence of dystyroidism in the study group was 44% (44 patients). Hypothyroidism is predominant (34 patients; 77%), and subclinical hypothyroidism occurs in 20 (59%) of subjects with hypothyroidism. Unstable angina is the predominant type of acute coronary syndrome, both in the whole group (54 patients; 54%) and in the group of patients with hyperthyroidism (7 patients; 70%), while acute myocardial infarction without ST-segment elevation was the type majority of presentation in patients with hypothyroidism (19 patients, 56%). Coronary heart disease varied as follows: in the total group unicoronary lesion (31 subjects; 31%), in patients with hyperthyroidism unicoronary lesion (5 subjects; 50%), in patients with hypothyroidism bicoronary lesion (10 subjects; 29%). And the calculated SYNTAX score is higher in the group of patients with dysthyroidism compared to the group of patients with euthyroidism. Discussions. Unstable angina (p = 0.006) and ventricular wall hypertrophy (p = 0.008) are predictive factors for dysthyroidism. Hypothyroidism correlates with high LDL-cholesterol levels (p = 0.0176) and hyposideremia (p = 0.0083), while hyperthyroidism correlates with thrombocytosis (p = 0.0122) and a significant nonspecific inflammatory syndrome (p = 0.0043). Dystyroidism has a direct correlation with the presence of kinetic disorders (Person correlation coefficient 0.21). Conclusion. Thyroid disease, with hypothyroidism or hyperthyroidism, can also be a risk factor for cardiovascular disease, and especially for ischemic heart disease.
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Stanojlović, Teodora, Milan Pavlović, Snežana Ćirić, Lazar Todorović, Svetlana Apostolović, Sonja Šalinger-Martinović, Milena Radosavljević, Svetlana Petrović-Nagorni, Vesna Atanasković, and Vesna Topić. "The role of echocardiography in acute coronary syndrome." Srce i krvni sudovi 33, no. 2 (2014): 87–91. http://dx.doi.org/10.5937/siks1402087s.
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Ranđelović, Miomir, Svetlana Apostolović, Milan Pavlović, Goran Koraćević, Zoran Perišić, Sonja Šalinger-Martinović, Marko Lazović, Snežana Ćirić-Zdravković, and Lazar Todorović. "Therapy of arrhythmias in acute coronary syndrome." Srce i krvni sudovi 33, no. 2 (2014): 143–48. http://dx.doi.org/10.5937/siks1402143r.
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., Birhasani, Lisyani B. S, and Ria T. "D-DIMER PENDERITA SINDROM KORONER AKUT DAN STENOSIS." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 17, no. 3 (April 4, 2018): 134. http://dx.doi.org/10.24293/ijcpml.v17i3.1092.
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Acute coronary syndrome (ACS) is the multisystem of coronary artery disease. The clinical manifestation of ACS is acute myocardialinfarction (AMI). About 90% coronary attack is caused by thrombus occlusion in coronary artery. The suspect of thrombosis can bediagnosed definitely by Angiography, but it is invasive. D-dimer used to measure thrombosis abnormality and fibrinolisys. The result oftheir correlation between D-dimer with ACS is still controversived. The aim of this research is to analyse, the different between plasmaD-dimer level ACS with stenosis ≥ 50% and stenosis < 50%. This study used a cross sectional design. The study consist of seventeenspecimen ACS with stenosis ≥ 50% and 17 specimen with stenosis < 50%. Plasma D-dimer level was measured with quantitativeagglutination latex method. An independent t-test statistical analysis is used in this study. The average Plasma D-dimer of ACS withstenosis ≥ 50% is 960.2 ± 404.99 µg/L thus ACS with stenosis < 50% is 300.3 ± 128.75 µg/L (p = 0.00). The plasma D-dimer levelof ACS with stenosis ≥ 50% is more significant than ACS with stenosis < 50%.
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Todorovic, Lazar, Vesna Atanasković, Vesna Mitić, Svetlana Petrović-Nagorni, Ružica Tomašević, Sonja Dakić, and Dragana Stanojević. "Therapy of heart failure in acute coronary sindroma." Srce i krvni sudovi 33, no. 2 (2014): 139–42. http://dx.doi.org/10.5937/siks1402139t.
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Apostolović, Svetlana, Milan Pavlović, Sonja Šalinger-Martinović, Miloje Tomašević, Nebojša Krstić, Miodrag Damjanović, Milan Živković, et al. "Spontaneous dissection of coronary arteries as a cause of acute coronary syndrome." Srce i krvni sudovi 32, no. 4 (2013): 2–13. http://dx.doi.org/10.5937/siks1301002a.
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Jovanović, Aleksandar, Todor Knežević, Jelena Niković, Snežana Tešović, Radoslav Pejin, and Sanja Tomić. "Possibilities and modes of medical rehabilitation of patients with concomitant occurence of acute coronary syndrome and acute stroke." Sestrinska rec 25, no. 85 (2022): 35–39. http://dx.doi.org/10.5937/sestrec2285035j.
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Background: Being the most austere manifestation of ischaemic heart disease, acute coronary syndrome is one of the most frequent causes of urgent treatment and sudden death in both developed and developing countries as well. Acute stroke is the third cause of death in developed countries, after cardiovascular diseases and tumors, and second worldwide. Besides being a disease with high mortality, it is also a disease with a highest level of disability. Aim: To determine possibilities and modes of rehabilitation of patients with concomitant occurence of acute stroke and acute coronary syndrome. Methods: Retrospective study using hospitalized patients data. 5929 hospitalized patients treated at the Institute for cardiovascular diseases in Sremska Kamenica were analyzed from January 1st 2017 to December 31st 2019, without regarding sex and age. We entered data in created database and analyzed using descriptive statistics and chi-square test. Results: Concomitant stroke and acute coronary syndrome was found in 61 patient (1.0%). There were 32 males and 29 females. Average age was 68.82. Pneumonia occured more frequently in persons with concomitant occurrence of acute stroke and acute coronary syndrome than in persons with acute coronary syndrome without acute stroke. Regarding neurological and/or cardiological condition, only 3 patients (9.0%) were eligible for rehabilitation, and in all others it was delayed or contraindicated. Conclusion: Rehabilitation of patients with concomitant occurrence of acute coronary syndrome and acute stroke was complicated, with high risk, and required multidisciplinary approach to each patient individually.
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Utama, Tuti Anggraini, Feni Eka Dianti, and Maiyulis Maiyulis. "KESEJAHTERAAN SPIRITUAL PASIEN PASCA SINDROM KORONER AKUT." JURNAL KEPERAWATAN MUHAMMADIYAH BENGKULU 9, no. 1 (April 17, 2021): 50–55. http://dx.doi.org/10.36085/jkmb.v9i1.1514.
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Post-acute coronary syndrome is the rehabilitation phase that can result in physical and psychological changes that affect the quality of life of the patient which then causes psychosocial problems in the form of anxiety and depression. This anxiety and depression has a correlation with spiritual well-being. The aim of this study was to identify the level of spiritual well-being in patients after acute coronary syndrome in RS cardiac polyclinic. Dr. M.yunus Bengkulu. This research is a quantitative descriptive study using the SIWB instrument. The population of this study were all patients with SKA in 2017, totaling 250 respondents in the last 6 months. This study used accidental sampling technique, amounting to 43 respondents. The results showed that most of the patients were with low spiritual well-being (23%). In conclusion, the patient's spiritual well-being is low, so there is a need for increased fulfillment of the spiritual needs of the family.
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DRĂGAN, Eleonora, Maria Suzana GUBERNA, Cătălina Liliana ANDREI, and Crina-Julieta SINESCU. "Evolutionary and prognostic implications in patient with acute coronary syndrome and dysthyroidism." Romanian Journal of Medical Practice 16, no. 2 (June 30, 2021): 225–33. http://dx.doi.org/10.37897/rjmp.2021.2.20.
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Purpose. The study aims to determine the impact of dysthyroidism on the severity and type of coronary lesion, on vascular function, as well as on the morbidity and mortality of patients with acute coronary syndrome, by finding predictive markers that can be translated into preventive measures that contribute substantially to reduce the number of newly diagnosed patients with coronary heart disease. Methods. We introduced in the study 100 patients recently diagnosed with acute coronary syndrome, without history of ischemic heart disease or thyroid disease, hospitalized in the Cardiology Clinic of the “Bagdasar-Arseni“ Emergency Clinical Hospital Bucharest, for the interventional treatment of acute coronary syndrome. The studied patients were hospitalized between November 2014 and April 2015, with regular follow-up of up to 5 years (telephone or direct interview, conducted at 6 months, 12 months, 24 months, 36 months, 48 months, 60 months), with an average period follow-up of 1006 days, evaluated clinically, bio-humorally, by echocardiography, explored with coronary angiography with the calculation of the SYNTAX score and with the performance of electrocardiogram and pulse wave. The obtained data were integrated in Excel sheets and statistically processed with the Python program. Results. The mortality rate in the patient group was 7% (7 deaths). Descriptively, of the deceased, 6 patients (86%) were male, and as thyroid status 1 hyperthyroid patient (14%), 3 hypothyroid patients (43%) and 3 patients (43%) normothyroid. There were 4 deaths (8%) in the group of patients with unstable angina and 3 deaths (8%) in the group of patients with myocardial infarction without ST-segment elevation. There were no deaths in the group of patients with acute myocardial infarction with ST-segment elevation. At follow-up, 41 patients (41%) were readmitted. Re-hospitalization was influenced by elevated values of mean blood pressure, diastolic blood pressure and C-reactive protein, unicoronary atherosclerotic disease and unstable angina at admission. At follow-up, the development of noncardiac events was noted in the evolution of patients, diabetes mellitus occurring in the majority, in almost a quarter of patients (22 patients, respectively 24% developed diabetes over time), 34% (19 patients) in euthyroidism and 8% (3 patients) dysthyroidism. Discussions. Predictive factors for the readmission of the patient with acute coronary syndrome are highlighted the following: increased level of C-reactive protein (p = 0.017), tricoronary vascular damage (p = 0.01), diastolic blood pressure greater than 80 mmHg (p = 0.025), and euthyroid status (p = 0.04). The probability of death for the patient with acute coronary syndrome rises to 66% in the presence of severe systolic dysfunction of the left ventricle (p = 0.006), and to 61% in the case of elevated values of hs troponin I (p = 0.008). In our study, the presence of dysthyroidism in the patient with acute coronary syndrome has a protective role in the development of diabetes in the first 5 years (p = 0.025). Conclusion. Dysthyroidism is associated with increased morbidity and mortality from cardiovascular disease.
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Kuljanin, Milica, Bojan Pavković, Aleksandra Huljić, Aleksandra Caričić, Bojan Prokić, and Marija Zarić. "Association of familial combined hyperlipidemia with acute coronary syndrome." Timocki medicinski glasnik 43, no. 4 (2018): 188–92. http://dx.doi.org/10.5937/tmg1804188k.
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BĂTĂILĂ, Vlad, Aura VÎJÎIAC, Lucian CÂLMÂC, and Maria DOROBANŢU. "Kounis syndrome – an unusual etiology of acute myocardial infarction." Romanian Journal of Medical Practice 10, no. 3 (September 30, 2015): 295–99. http://dx.doi.org/10.37897/rjmp.2015.3.15.
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Kounis syndrome is defined as an association between an acute coronary syndrome and acute systemic allergy involving vasoactive mediators released during the activation of the mast cells. A 79 year old woman arrives at the emergency department with syncope; she was stung by a wasp an hour before symptoms’ onset. Clinical examination was normal, excepet her left upper limb which had important edema. The ECG revealed ST-segment elevation in the inferior leads and negative T waves in the anterior leads. Emergency coronary angiography was performed, which revealed a 40% stenotic plaque on the mid LAD. A conservative approach was decided. The patient received standard anti-ischemic treatment and she was safely discharged after 6 days. We considered this case a Kounis syndrome induced by a wasp sting associated with a silent inferior myocardial infarction.
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Nency, Cahyu, Muhammad Kevin Surya, and Andy Kurnia. "Gagal Jantung Akut sebagai Komplikasi Sindrom Koroner Akut." Cermin Dunia Kedokteran 50, no. 1 (January 4, 2023): 30–35. http://dx.doi.org/10.55175/cdk.v50i1.336.
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Gagal jantung akut adalah kondisi medis yang dapat mengancam nyawa ditandai dengan perburukan gejala dan tanda gagal jantung. Gagal jantung akut dapat disebabkan oleh sindrom koroner akut subset ST elevation myocardial infarction (STEMI). Perlu diagnosis yang cepat dan tata laksana yang tepat guna menurunkan risiko morbiditas, re-hospitalisasi, dan mortalitas gagal jantung akut.
Acute heart failure is a life-threatening condition characterized by worsening symptoms and signs of heart failure. Acute heart failure can occur with acute coronary syndrome with ST elevation myocardial infarction (STEMI). Rapid diagnosis and appropriate management is required to reduce its morbidity, re-hospitalization, and mortality.
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Purwowiyoto, Sidhi Laksono. "Coronary CT Angiography in Emergency Department: Can We Use It?" Indonesian Journal of Cardiology 38, no. 4 (August 19, 2018): 234–38. http://dx.doi.org/10.30701/ijc.v38i4.789.
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Acute chest pain syndrome is the main cause of patients come to emergency department. Identifying those with anamneses, risk factors, physical examination, ECG and laboratory remain challenging to exclude the acute coronary syndrome, especially those with low risk probability. Early imaging examination is important for risk stratification of these groups. Utilization of coronary CT angiography quickly identifies a group of low risk patients and allows safe and expedited discharge.
Abstrak
Sindroma nyeri dada akut merupakan penyebab utama pasien datang ke unit gawat darurat. Mengidentifikasi mereka dengan anamnesis, faktor risiko, pemeriksaan fisik, EKG dan laboratorium tetap menantang untuk dapat menyingkirkan sindroma koroner akut, terutama yang dengan probabilitas risiko rendah. Pemeriksaan pencitraan awal penting untuk stratifikasi risiko kelompok ini. Penggunaan angiografi CT koroner dengan cepat mengidentifikasi kelompok pasien dengan risiko rendah dan memungkinkan pasien dipulangkan secara aman dan cepat.
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Skopets, Inga Sergeevna, Natal'ya Nikolaevna Vezikova, Irina Mikhaylovna Marusenko, and Aleksandr Nikolaevich Malygin. "Ostryy koronarnyy sindrom: kompleksnyypodkhod v taktike vedeniya patsientov,rol' pervichnoy i vtorichnoy profilaktiki." CardioSomatics 2, no. 1 (March 15, 2011): 9–12. http://dx.doi.org/10.26442/cs44954.
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Summary. The article analyzes the clinical course, tactics and long-term outcomes in patients with acute coronary syndrome treated at the Regional Vascular Center. An important aspect is not only medication and treatment tool in the acute phase, but also an adequate primary and secondary prevention, which can contribute to improving the quality of life for patients, reducing mortality, economic costs as well as clinical and social consequences of coronary heart disease.
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Kocić, Sanja, Svetlana Radević, Saša Piskulić, Gordana Kovačević, Jelisaveta Radulović, Dejan Živanović, Bojana Trikoš, Slavica Bogdanović, and Zorica Stevanović. "Epidemiological characteristics of acute coronary syndrome in the Sumadija district." Zdravstvena zastita 47, no. 4 (2018): 30–36. http://dx.doi.org/10.5937/zz1803030k.
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Hinić, Saša. "Acute coronary syndrome without persistent elevation of the ST segment: New recommendations." Galenika Medical Journal 1, no. 1 (2022): 105–10. http://dx.doi.org/10.5937/galmed2201105h.
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Acute myocardial infarction without persistent ST-segment elevation is a serious medical problem that significantly increases cardiovascular mortality and morbidity. Therefore, timely accurate diagnosis is crucial for adequate treatment of these patients, better survival and improved quality of life. It is characterized by a clinical picture of acute chest discomfort that may occur in the form of typical anginal problems or as the equivalent of acute chest pain. Changes in the electrocardiogram are varied, from transient ST-segment elevation, persistent or transient ST-segment depression, T-wave inversion, flattened T-wave, or pseudonormalization of the T-wave, to normal electrocardiographic recording. The latest guidelines of the European Society of Cardiology advise determining the value of cardio-specific enzymes from the patient's blood, namely high-sensitivity cardiac troponin T or I immediately upon admission to the health institution and repeated one hour after admission (0h / 1h algorithm). Echocardiographic examination is recommended in all patients as a routine procedure before admission or during hospitalization. Coronary CT angiography for the anatomical evaluation of coronary heart disease is important in patients with a low to moderate probability of an acute coronary event. Drug treatment in these patients involves the use of dual antiplatelet therapy to determine the ischemic risk of the patient as well as the risk of bleeding. Pre-treatment with the use of primarily P2Y12 receptor inhibitors is not recommended in routine clinical practice. In patients who have undergone revascularization and stent implantation, dual antiplatelet therapy is recommended for 12 months, except in cases where there are contraindications or increased hemorrhagic risk. Patients who require long-term use of oral anticoagulant therapy after a short period of triple antiplatelet therapy up to 1 week after the acute event, continue dual antiplatelet therapy, using new anticoagulants at the recommended dose to prevent stroke and one oral antiplatelet drug. Invasive coronary angiography can be performed according to the patient's risk immediately after admission to a health institution (within 2 hours) in very high-risk patients or as an early treatment strategy, within 24 hours of admission in high-risk patients. To perform an invasive intervention, a radial approach is advised, as well as the implantation of drug-coated stents. In patients in whom it is not possible to perform myocardial revascularization by percutaneous coronary intervention, revascularization with coronary artery bypass grafts is recommended. In the long-term follow-up of these patients, after an acute coronary event, it is advisable to change life habits with pharmacological treatment, which reduces mortality and improves the quality of life.
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Ognjenović, Areta. "Nursing interventions in the treatment of syndrome Takotsubo // Zadaci kardiološke medicinske sestre u lečenju Takotsubo sindroma." SESTRINSKI ŽURNAL 5, no. 1 (November 28, 2018): 45. http://dx.doi.org/10.7251/sez0118045o.
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Takostube syndrome (TS; broken heart syndrome) is described as transient reversible cardiomyopathy that occurs in older women in most cases as a result of mental or psychological suffering. It is associated with various disorders and it is defined as Takotsubo Syndrome (TS). The clinical picture is similar to acute coronary syndrome, but it must differ from acute ischemic heart disease. Ethiopathological factors have not been fully clarified, but the main role in the development of TS by catecholamine-induced spiking myocardial capillaries or the direct toxicity of catecholamines themselves.There are no strict guidelines in the implementation of health care for patients with TS. Given the great similarity in the clinical picture between acute myocardial infarction and TS, the same procedures and tasks are used in practice as in patients with acute myocardial infarction with ST elevation, while coronarography does not prove to be the opposite. The patient under suspicion of diagnosis of TS is admitted to the coronary unit.Healthcare goals for the treatment of patients with TS are identical to those in acute coronary syndrome and include: pain relief, tension reduction - anxiety, preservation of myocardial function, and prevention and treatment of complications.
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Kačar, Saša, and Mirjana Kačar. "Myocardial revascularization in patients with acute coronary syndrome." Srce i krvni sudovi 32, no. 4 (2013): 298–303. http://dx.doi.org/10.5937/siks1304298k.
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Prabundari, Anak Agung Yunda, Ketut Suardamana, Ketut Suryana, and Tjok Istri Anom Saturti. "Hubungan antara peningkatan kadar immunoglobulin-e (IgE) dengan matrix metalloproteinase-9 (MMP-9) pada pasien sindrom koroner akut (SKA) di RSUP Sanglah, Denpasar, Bali." Intisari Sains Medis 11, no. 3 (December 1, 2020): 1519–21. http://dx.doi.org/10.15562/ism.v11i3.641.
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Introduction. Acute Coronary Syndrome (ACS) is a cardiovascular disease that has a high mortality rate. One of the markers which play a role in the pathophysiology of ACS is Immunoglobulin E (Ig E), one of the antibodies released by B lymphocytes as the result of complex interactions that can activate mast cells. Mast cells will activate Metalloproteinase-9 (MMP-9) then facilitate pathogenesis of acute myocardial infarction or acute coronary syndrome phase. This study aimed to determine the relationship between increasing levels of IgE and MMP-9 in ACS patients at Sanglah Hospital, Denpasar, Bali.Method. This was a cross-sectional analytic study, and the samples were collected from ACS patients at Sanglah Hospital, Denpasar, Bali, using a consecutive sampling method. A total of 73 samples were included in this study, then statistical tests and Pearson correlation test was conducted.Results. Seventy-three samples included in this study contain 59 men (80.8%) and 14 women (19.2%). The IgE level is between 0.5-1000 and MMP-9 levels between 6.91-29.56. There is a statistically significant correlation between IgE levels and MMP-9 levels in Acute Coronary Syndrome patients (p = 0.018: r = 0.277).Conclusion. We found a significant association between increased IgE and MMP-9 in patients with Acute Coronary Syndrome at RSUP Sanglah, Denpasar, Bali. Pendahuluan. Sindrom Koroner Akut (SKA) merupakan penyakit kardiovaskular dengan angka kematian yang sangat tinggi. Salah satu marker yang berperan dalam patofisiologi SKA adalah Immunoglobulin E (IgE). IgE merupakan salah satu antibodi yang dilepaskan oleh limfosit B sebagai interaksi kompleks yang dapat mengaktivasi sel mast. Sel mast yang sudah aktif akan mengaktivasi Metallopriteinase-9 (MMP-9) yang ikut berperan dalam patogenesis miokard infark akut atau sindrom koroner akut. Penelitian ini bertujuan unuk mengetahui hubungan peningkatan kadar IgE dan MMP-9 pasien SKA di RSUP Sanglah, Denpasar, Bali.Metode. Penelitian ini merupakan penelitian potong lintang analitik yang dilakukan pada populasi SKA di RSUP Sanglah, Denpasar, Bali. Sampel keseluruhan berjumlah 73 orang pasien SKA secara konsekutif diikutsertakan dalam penelitian ini, kemudian dilakukan uji statistik dan uji korelasi Pearson.Hasil. Dari hasil penelitian pada 73 sampel tersebut, didapatkan jumlah sampel 59 orang laki-laki (80,8%) dan 14 orang perempuan (19,2%). Adapun kadar IgE dalam rentang antara 0,5-1000 dan kadar MMP-9 antara 6,91-29,56. Terdapat korelasi yang bermakna antara kadar IgE dengan kadar MMP-9 pada pasien Sindrom Koroner Akut (p=0,018; r=0,277).Kesimpulan. Terdapat hubungan yang signifikan antara peningkatan kadar IgE dengan peningkatan kadar MMP-9 pada pasien Sindrom Koroner Akut di RSUP Sanglah, Denpasar, Bali.
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Nawawi, R. A., Fitriani ., B. Rusli, and Hardjoeno . "NILAI TROPONIN T (cTnT) PENDERITA SINDROM KORONER AKUT (SKA)." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 12, no. 3 (March 15, 2018): 123. http://dx.doi.org/10.24293/ijcpml.v12i3.872.
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Acute Coronary Syndrome (ACS) is an emergency cardiac condition manifested by chest pain or other symptoms as the result ofischemic myocardium. Myocardial damage can be detected by Creatine Kinase MB (CK-MB), Lactate Dehydrogenase (LDH) and cTnTtests. CTnT can be used as criteria of therapy determination. The combination of CK-MB and cTnT are the most effective tests if theearly myocardium damage is unknown, to evaluate cTnT, CK-MB, and LDH values in patients with Acute Coronary Syndrome (ACS) atWahidin Sudirohusodo Hospital, Makassar. Secondary data were collected from the medical records (from March to July 2005 period)at Wahidin Sudirohusodo Hospital, Makassar. Chi-square and Spearman correlation were carried out to analyze the collected data. Theinvestigators found 90 patients with ACS consisted of 57 males (63.33%) and 33 females (36.67%). The highest cTnT Value of 0.1 to2.0 ng/ml was found in 39 patients (43.33%), 30 females (52.63%). Significant correlation showed by Chi-square test between IMAEKG and cTnT values (p < 0.05). Spearman correlation test demonstrated significant correlation between cTnT value and CK-MB andLDH (p = 0.001). Most cTnT values were found in the male patients with ACS, aged 60 to 69 years and significantly correlated withIMA’s ECG, CK-MB and LDH.
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Puspitawati, Ira, I. Nyoman G. Sudana, Setyawati Setyawati, and Usi Sukorini. "HEART FATTY ACID BINDING PROTEIN SEBAGAI PETANDA BIOLOGIS DIAGNOSIS SINDROM KORONER AKUT." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 22, no. 2 (March 27, 2018): 127. http://dx.doi.org/10.24293/ijcpml.v22i2.1114.
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Heart-Fatty Acid-Binding Protein (H-FABP) is a membrane-bound protein that facilitates transport of fatty acids from the blood intothe heart. It is a low molecular weight cytoplasmic protein. Because of its small size and location, it is released rapidly into the bloodfollowing myocardial damage. The H-FABP levels rise as early as between 1−3 hours after the onset of Acute Coronary Syndrome, thepeak situation between 6−-8 hours, and returns to normal within 24 hours. The purpose of this study was to know the cut-off value ofHeart Fatty Acid Binding Protein with a sensitivity of at least 90% in patients with acute coronary syndrome in the Dr. Sardjito HospitalYogyakarta. The researchers undertook a cross sectional evaluation of 75 consecutive patients admitted with acute chest pain suggestiveof acute coronary syndrome (ACS). The H-FABP was measured by using immunoturbidimetry assay methods. The receiver operatingcharacteristic (ROC) analysis was calculated for the cut off point, sensitivity and specificity estimation. A total of 75 patients (59 in theACS group and 16 in the control group) were included in this study, and the majority of the ACS group (64 [76.2%]) were male patientswith AMI, 20 (26.7%) had an ST-elevation myocardial infarction and the rest (21 [28%]) had a non–ST-elevation myocardial infarction.The optimized cut-off obtained for h-FABP was 15 ng/mL, showing a sensitivity and specificity of the H-FABP assay for detecting ACSas 98.31 (95% CI 90 to 100) and 93.75% (95% CI 86 to 99), respectively. The areas under the receiver operator characteristic (ROC)curves to distinguish ACS from non-ACS were 0.983 (95% CI: 0.927– 0.999) for H-FABP. The optimized cut-off obtained for H-FABPwas 15 ng/mL, showing a 98.31% sensitivity and 93.75% specificity for detecting ACS in the Dr. Sardjito Hospital Yogyakarta.
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Kurnia, Andy. "Diagnosis dan Tatalaksana Infark Miokard Akut Ventrikel Kanan." Cermin Dunia Kedokteran 47, no. 8 (August 1, 2020): 413. http://dx.doi.org/10.55175/cdk.v47i8.772.
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<p>Infark miokard akut ventrikel kanan (IMA-VKa) merupakan salah satu sindrom koroner akut (SKA) memiliki angka kejadian cukup tinggi. Perlu diagnosis serta tatalaksana secara cepat, tepat, dan akurat guna mengurangi angka morbiditas dan mortalitas.</p><p>Right ventricle acute myocardial infarction is an acute coronary syndrome with high prevalance. Prompt and accurate diagnosis and management is needed to reduce morbodity and mortality.</p>
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Lazarević, Marija. "Acute coronary syndrome and anxiety in patients who complain of chest pain." Psihijatrija danas 49, no. 2 (2017): 151–59. http://dx.doi.org/10.5937/psihdan1702151l.
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Dragović, Gordana, Dragana Malović, and Đorđe Jevtović. "Metabolic syndrome and combined highly active antiretroviral therapy." Medicinska istrazivanja 48, no. 1 (2014): 24–31. http://dx.doi.org/10.5937/medist1401024d.
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Metabolic complications, including dyslipidemia, insulin resistance, and altered fat distribution, (i.e. lypodistrophy), which is manifested as a loss of subcutaneous fat and a relative increase in central fat, are common in adults infected with hu-man immunodeficiency virus (HIV) who are receiving highly active antiretroviral therapy (HAART). These metabolic COM-plications increase the risk of cardiovascular disease (coronary disease, acute myocardial infarction) and cerebrovascular disease, increasing morbidity and mortality in this population. Metabolic syndrome is the consequence of the dynamic relationship between HIV virus and a host, which is influenced by the viral characteristics, genetic factors of a host, environ-mental factors, and the HAART. The potential to induce metabolic syndrome varies among antiretroviral drugs from of the same class, as well as between different classes of drugs. The development of algorithms for the screening, prediction, prevention and treatment of cardiovascular disease is the new challenge for the doctors and requires new studies in this area.
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Šalinger-Martinović, Sonja, Milan Pavlović, Svetlana Apostolović, Lazar Todorović, Zoran Perišić, Miodrag Damjanović, Nebojša Krstić, et al. "Evaluation of ischemic and hemorhagic risk in patients with acute coronary syndrome." Srce i krvni sudovi 33, no. 2 (2014): 105–9. http://dx.doi.org/10.5937/siks1402105s.
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Oktarina, Rosi, Yertizal Karani, and Zulkarnain Edward. "Hubungan Kadar Glukosa Darah Saat Masuk Rumah Sakit Dengan Lama Hari Rawat Pasien Sindrom Koroner Akut (SKA) Di RSUP Dr. M. Djamil Padang." Jurnal Kesehatan Andalas 2, no. 2 (May 1, 2013): 94. http://dx.doi.org/10.25077/jka.v2i2.128.
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AbstrakHiperglikemia masih menjadi topik penelitian yang sering dihubungkan dengan kejadian sindrom koroner akut (SKA) di dunia, terutama hiperglikemia saat masuk rumah sakit. Hal ini didasari oleh beberapa pengaruh kadar glukosa darah yang tinggi terhadap sistem kardiovaskuler seperti gangguan fungsi ventrikel kiri, stroke volume yang menurun, regurgitasi katup mitral berulang, gangguan pada waktu pengisian diastolik hingga risiko tinggi untuk arritmia, serta hubungannya dengan peningkatan risiko trombosis. Sehingga semakin memperjelas pengaruh hiperglikemia yang tidak hanya dapat meningkatkan risiko terjadinya SKA, melainkan juga dapat memperburuk kondisi pasien SKA sendiri. Penelitian ini bertujuan mengidentifikasi hubungan kadar glukosa darah sewaktu dengan lama hari rawat pasien Sindrom Koroner Akut (SKA). Jenis penelitian yang digunakan adalah penelitian analitik dengan menggunakan desain penelitian Cross Sectional Study. Penelitian ini menggunakan data sekunder yang diambil di Instalasi Rekam Medik (Medical Record), yakni data rekam medik pasien yang didiagnosis sebagai Sindrom Koroner Akut (SKA) yang dirawat inap di Rumah Sakit Umum Pusat DR. M. Djamil Padang Periode Januari–Desember 2011. Ditemukan sebagian besar pasien SKA masuk rumah sakit dengan kadar Glukosa Darah Sewaktu (GDS) sebesar ≥ 200 mg/dl (40%) dan lama hari rawat sebesar ≥ 7 hari (52%). Dari hasil analisa bivariat dengan menggunakan uji korelasi Spearman ditemukan adanya hubungan searah antara kadar glukosa darah saat masuk rumah sakit dengan lama hari rawat pasien SKA dengan kekuatan hubungan yang sedang, r = +0,492, p = 0, 000 (p<0,05). Pemantauan terhadap kadar GDS yang diperiksa saat pasien masuk rumah sakit perlu dilakukan dan untuk penelitian yang akan datang diharapkan dapat diteliti lebih lanjut faktor-faktor lain yang mempengaruhi lama hari rawat pasien SKA.Kata kunci: Kadar glukosa darah saat masuk RS, lama hari rawatAbstractHyperglicemia is still become a research topic which is often associated with the incidence of Acute Coronary Syndrome (ACS) in the world, especially hyperglicemia on hospital admission. This is due to several effects of high random blood glucose to the cardiocasculer system for instance impaired left ventricular function, decreased stroke volume, reccurrent mitral valve regurgitation, impaired diastolic filling, high risk arrhytmias and its corelation with the increase thrombosis risk. This circumstance explains more about the effects of hyperglicemia that not only increase the risk of Acute Coronary Syndrome (ACS), but can also worsen the Acute Coronary Syndrome (ACS) patients condition through a various of mechanisms. This research is purposed to identify the relation between hospital admission blood glucose level with length of stay of Acute Coronary Syndrome (ACS). This research uses analytic research which is using cross sectional design. This research uses secondary data that is taken from the medical records of patients diagnosed as Acute Coronary Syndrome (ACS) admitted to RSUP DR. M. Djamil Padang from January until December 2011. Research found that the most of ACS patients admitted to the hospital with as random blood glucose of ≥200 mg/dl (40%) and length of stay for ≥7 days (52%). The results of bivariate analysis by using Spearman correlation test is obtained the correlation between hospital admission blood glucose level to length of stay ACS patients and the strength of correlation is moderate, r = +0,492 , p = 0, 000 (p<0,05). The monitoring of random glucose level of ACS patients upon hospitalization is necessary and for future studies the other factors that affect the length of stay of ACS patients should be considered.Keywords:Hospital admission blood glucose, length of stay
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Puspitawati, Ira, Setyawati Setyawati, Dyah Wulan Anggrahini, Diah Saraswati, and Aisyah Ratna Yuniarti. "LIPOPROTEIN(a) DAN KEBAHAYAAN SINDROM KORONER AKUT." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 21, no. 2 (March 27, 2018): 179. http://dx.doi.org/10.24293/ijcpml.v21i2.1104.
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One of the risk factors of Acute Coronary Syndrome (ACS) still controversial is Lipoprotein(a). Lp(a) is one of the lipid componentshighly homologous to plasminogen and which may compete with it in the fibrinolytic pathway and has an atherogenic effect. Prior to thestudy many variaties in results have been shown. These variations are related to different population and ethnics, thus, the researcherswere triggered to investigate the role of Lp(a) on the ACS in the Indonesian population. This case control study was conducted at theSardjito General Hospital, Yogyakarta, Indonesia consisting of 40 participants in ACS as the case group and other 40 persons sufferingfrom Stable Angina Pectoris (SAP) as a control group. This study lasted from May−December 2011. The Lp(a) was measured usingturbidimetric immunoassay method while other laboratory results were obtained from the medical records. The results of this studyshowed that high Lp(a) level (more than 30 mg/dL) was the risk factor of ACS (RR=2.818, CI: 1.069–7.426). There was no difference ofthe baseline characteristics such as: the history of hypertension, diabetes mellitus, smoking, as well as in other laboratory parameters suchas: lipid profile, hemoglobine and uric acid level in the case as well as the control group. Significant differences were found in leucocytenumber, creatinine and blood glucose level. The median level of those parameters was found higher in the case group.
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Todorović, Gordana, Aleksandar Joldžić, and Dragana Vesić. "The importance of prehospital recognition of ST segment elevation in the aVR lead in acute coronary syndrome." Naucni casopis urgentne medicine - Halo 194 26, no. 1 (2020): 15–21. http://dx.doi.org/10.5937/halo56-25656.
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Candradewi, Susan Fitria, Dyah Aryani Perwitasari, and Nabilah Nabilah. "Analisis Biaya dan Luaran Klinis Sindrom Koroner Akut Berbasis Clinical Pathway." JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) 11, no. 2 (June 30, 2021): 91. http://dx.doi.org/10.22146/jmpf.51176.
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Health clinicians often show different variations in the choice of therapy they prescribe for patients depending on their expertise, knowledge, and even their art. This is likely to affect several things, including the cost that patients have to pay. Such a difference in costs is avoidable by applying scientific evidence-based medical service standards and having measurable outcomes known as Clinical Pathways. A clinical pathway serves as a tool to measure the quality of health services based on the standardization of the treatment process. This research was designed to determine the cost analysis of treatments received by patients with acute coronary syndrome (ACS) according to the clinical pathway. This non-experimental research employed a retrospective cohort study design. The data were gathered from the medical records of ACS patients who were treated at the ICCU of PKU Muhammadiyah Hospital in Yogyakarta, and the costs incurred were compared between treatments that matched and did not match the clinical pathways. The inclusion criteria were ACS patients treated during 2016 who were between ≥ 18 and <75 years old and had complete data. Meanwhile, the exclusion criteria were ACS patients who had incomplete data, tumor malignancy, and a creatinine level of > 3 mg/dL. Here, therapies given to patients are concluded to fit the clinical pathway if they are precisely the same (100%) as the Clinical Practice Guide used by this hospital. The clinical outcome was measured from the patient’s length of stay (LOS). During the data analysis, the costs of ACS patient treatments that were compliant and non-compliant with the clinical pathway were compared based on the level of severity using the Mann-Whitney test in the SPSS program. The results showed that of the 63 patients, 31 received treatments according to the clinical pathway, while the other 32 did not. The average LOS of the former and the latter were, respectively, 4.45 and 5.53 (p= 0.043), with the total costs of treatments up to IDR5,474,001,73 and IDR6,728,153.13 (p= 0,154). Conformity to a clinical pathway significantly influences the length of stay but does not affect the cost of care for acute coronary syndrome patients.
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Sabebegen, Eka Musmita, Rismawati Yaswir, and Efrida Efrida. "Gambaran Castelli’s Risk Index-1 pada Pasien Sindrom Koroner Akut di RSUP Dr. M. Djamil Padang." Jurnal Kesehatan Andalas 10, no. 2 (September 12, 2021): 102. http://dx.doi.org/10.25077/jka.v10i2.1719.
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Atherogenic dyslipidemia is one of the risk factors for the acute coronary syndrome (ACS). Castelli's risk index-1 (CRI-1) is one of which risk markers for ACS. Castelli's risk index-1 is the ratio of total cholesterol and HDL cholesterol. The test is cheap and easy to do in the hospital setting. Objectives: To described CRI-1 in ACS patients in Dr. M. Djamil Padang Hospital. Methods: This descriptive study was carried out in the central laboratory and the CardioVascular Care Unit (CVCU) of Dr. M. Djamil Hospital Padang from September 2017 to September 2018. The population was all ACS patients who have been diagnosed by the clinician. The samples were part of the population that meet the inclusion and exclusion criteria. Colorimetric enzymatic method using automated clinical chemistry used to measure total cholesterol and HDL cholesterol. Results: This study used CRI-1> 4. Data were presented descriptively in a frequency distribution table. Seventy ACS patients were consisting of 50 (71.43%) males and 20 (28.57%) females, with a median age of 60.1 (8.93) years old. The median total cholesterol and HDL cholesterol levels were 178.66 (46.84) mg / dL respectively and 35.71 (10.86) mg / dL. CRI-1 mean is 5.43 (2.27). 81.43% CRI-1 subject results were more than four. Conclusion: The low levels of HDL cholesterol and within normal median total cholesterol level made CRI-1 value increased.Keywords: Acute coronary syndrome, Castelli’s risk index-1
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Pejčić, Ana, Radmila Obradović, Marija Bradić-Vasić, Ivan Minić, and Džemil Kurtagić. "Periodontal health and detection of periodontal bacteria in patients with acute coronary syndrome." Acta stomatologica Naissi 36, no. 82 (2020): 2079–90. http://dx.doi.org/10.5937/asn2082079p.
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Introduction: Recent studies have found that patients with periodontitis have greater risk of incurring fatal cardiovascular disease than patients without periodontitis. Emerging research has identified inflammation caused by periodontitis as significantly increasing the risk for ACS. Aim: The aim of this study was to investigate a periodontal status in the patients with ACS, and to assess the association of different periodontal parameters with ACS. Material and methods: In the first group, patients both with ACS and periodontitis were enrolled as cases. Patients were examined 3 days after ischemia. The second group consisted of patients who had only periodontitis. The control group consisted of healthy individuals. Periodontal parameters were measured and matched on the basis of demographic characteristics and assessed between the groups. The severity of periodontitis in both cases was analyzed. Results: Analysis of the periodontal parameters showed that median scores were higher in patients in the first and the second group compared to the third control group but significantly higher in group with ACS. Levels of inflammatory markers were highest in the first group, compared to the second group and the control group. Periodontal pathogens were more strongly present in patients with ACS than in the group with periodontitis, indicating that it was a serious illness in these patients. Conclusion: This study supports an association between periodontitis and ACS. Severe periodontitis is present in this patients indicating that periodontitis can further act on the development of ACS.
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Wismayana, I. Putu Ary, and I. Ketut Suardamana. "Seorang penderita syok anafilaksis dengan allergic myocardial infarction (kounis syndrome)." Intisari Sains Medis 12, no. 3 (December 30, 2021): 1031–36. http://dx.doi.org/10.15562/ism.v12i3.1207.
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Background: Kounis syndrome (KS) is defined as the concurrence of acute coronary syndromes associated with mast-cell and platelet activation in the setting of allergic or anaphylactic insults. Prevalence of KS is considered rare, estimated 1.1% of hospitalized allergic reaction patient, with mortality rate 7%. Case Report: Case of 39 years old male without history of coronary artery disease, having dyspnea, chest discomfort, and pruritus after eating skipjack tuna. 12 lead electrocardiogram showing ST depression segment on lead II, III, and aVF. Patient diagnose as Kounis syndrome variant type I. Treatment of Kounis Syndrome begins with cessation of the causative agent. After therapy using epinephrine and intravenous corticosteroid, clinical improvement was achieved, and ST segment depression on electrocardiogram resolved. Conclusion: Kounis syndrome is a rare disorder which need careful assessment and swift management. The diagnosis confirmed with sign and symptoms of allergic along with disorder in cardiovascular system. Latar Belakang: Kounis Syndrome (KS) didefinisikan sebagai sindrom koroner akut yang terjadi bersamaan dengan aktivasi sel mast dan trombosit dalam keadaan alergi atau anafilaksis. Prevalensi KS tergolong jarang, diperkirakan 1,1% dari pasien reaksi alergi yang dirawat di rumah sakit, dengan angka kematian 7%. Laporan Kasus: Laki-laki 39 tahun tanpa riwayat penyakit jantung koroner, sesak nafas, rasa tidak nyaman di dada, dan pruritus setelah makan ikan cakalang. Elektrokardiogram 12 sadapan menunjukkan segmen depresi ST pada sadapan II, III, dan aVF. Diagnosis pasien sebagai sindrom Kounis varian tipe I. Pengobatan Sindrom Kounis dimulai dengan penghentian agen penyebab. Setelah terapi menggunakan epinefrin dan kortikosteroid intravena, perbaikan klinis dicapai serta depresi segmen ST pada elektrokardiogram teratasi. Simpulan: Kounis syndrome adalah kelainan langka yang membutuhkan penilaian yang cermat dan penanganan yang cepat. Diagnosis ditegakkan dengan adanya tanda dan gejala alergi disertai gangguan pada sistem kardiovaskular.
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Jovanović-Vasiljević, Nada, and Slavica Simeunović. "The risk of appearance of acute coronary syndromes and arrhythmia at the alcoholics in the early abstinence period." Zdravstvena zastita 40, no. 6 (2011): 61–66. http://dx.doi.org/10.5937/zz1105061j.
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Kambu, Irwan. "TERAPI AKUPRESUR SEBAGAI EVIDENCE BASED NURSING UNTUK MENGURANGI NYERI DADA PADA PASIEN SINDROM KORONER AKUT." Journal of Health, Education and Literacy 2, no. 2 (March 31, 2020): 69–73. http://dx.doi.org/10.31605/j-healt.v2i2.614.
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Abstrak
Penyakit jantung koroner secara klinis ditandai dengan nyeri dada akibat sumbatan di arteri coroner. Akupresur merupakan bagian terapi komplementer yang mampu meningkatkan kadar endorfin untuk merangsang penurunan nyeri. Pelaksanaan evidence based nursing akupresur ini diberikan pada 8 pasien dengan teknik pemilihan purposive sampling. Instrument penerapan menggunakan skala penilaian nyeri visual analog scale. Penerapan akupresur diberikan selama 20 menit pada titik akupresur L14 dengan skala nyeri 0 sampai 5. Hasil dari 8 sampel yang diberikan akupresur semua pasien mengalami penurunan skala nyeri. Penekanan atau sentuhan pada titik akupresur dapat meningkatkan kadar endorfin dalam darah maupun sistemik. Endorfin merupakan opiat tubuh secara alami dihasilkan oleh kelenjar pituitary yang berguna untuk mengurangi nyeri, mempengaruhi memori dan mood yang kemudian akan memberikan perasaan relaks. Terapi akupresur terbukti mampu menurunkan nyeri sehingga bermanfaat untuk diterapkan pada pasien akut koroner sindrom dengan keluhan nyeri dada.
Abstract
Coronary heart disease is clinically characterized by chest pain due to a blockage in the coronary arteries. Acupressure is part of complementary therapy that is able to increase endorphin levels to stimulate pain reduction. The implementation of evidence based nursing acupressure was given to 8 patients with a purposive sampling technique. The application instrument uses a visual analog pain scale rating scale. The application of acupressure was given for 20 minutes at the L14 acupressure point with a pain scale of 0 to 5. The results of the 8 samples given acupressure all patients experienced a decrease in pain scale. Emphasis or touch on the acupressure point can increase blood and systemic endorphin levels. Endorphins are the body's opiates naturally produced by the pituitary gland which are useful for reducing pain, affecting memory and mood which will then relax. Acupressure therapy has been proven to reduce pain so it is useful to apply to acute coronary syndrome patients with chest pain.
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Ariany, Septa, Ivan Joalsen Mangara Tua, Danial Danial, and Nataniel Tandirogang. "PERBEDAAN NILAI RASIO NEUTROFIL-LIMFOSIT PRE DAN POST OPERASI CORONARY ARTERY BYPASS GRAFTING ON-PUMP TERHADAP KEJADIAN ACUTE KIDNEY INJURY DAN NON-ACUTE KIDNEY INJURY." Jurnal Kedokteran Mulawarman 8, no. 3 (December 22, 2021): 109. http://dx.doi.org/10.30872/j.ked.mulawarman.v8i3.6749.
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Acute Kidney Injury (AKI) adalah sindrom kompleks yang ditandai dengan penurunan fungsi ginjal. Pada penelitian ini, rasio neutrofil-limfosit (RNL) yang tinggi dikaitkan dengan perkembangan AKI setelah Coronary Artery Bypass Grafting On-Pump (CABG on-pump). Penggunaan RNL sebagai parameter yang tersedia dengan mudah untuk mendeteksi pasien yang berisiko terkena AKI. Tujuan penelitian untuk mengetahui perbedaan nilai RNL pasca operasi CABG on-pump terhadap kejadian AKI dan Non-AKI. Penelitian ini merupakan penelitian analitik dengan pendekatan cross sectional. Semua data klinis preoperative dan postoperative diambil sebagai data sekunder dari rekam medik pasien yang menjalani CABG di Rumah Sakit Umum Daerah Abdul Wahab Sjahranie (RSUD AWS) Samarinda periode Januari 2017-Desember 2020. Penelitian menggunakan uji statistik dengan Mann-Whitney dan Uji Regresi. Hasil penelitian ini ditemukan 41,1% dari 56 sampel mengalami AKI. Hasil didapatkan bahwa terdapat perbedaan nilai RNL pasca operasi pada sampel AKI dan Non-AKI dengan nilai p=0,008. Peningkatan RNL ≥ 10 kali risiko sebesar 6,352 kali lipat.
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Filipović, Aleksandra, and Janko Janković. "Assessing different determinants influencing the death outcome resulting from acute coronary syndrome in patients treated in the coronary unit of the general hospital in Valjevo, and their differences." Srpski medicinski casopis Lekarske komore 3, no. 4 (2022): 403–20. http://dx.doi.org/10.5937/smclk3-40807.
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Introduction: Cardiovascular diseases are the leading cause of morbidity and mortality in most countries of the world and are responsible for the death of 17.9 million people per year and for 11.8% of total DALYs. In Serbia, acute coronary syndrome (ACS) is the main cause of death among ischemic heart diseases, with a share of 49.9%. Aim: The aim of the study is to examine the association of various determinants (demographic, anthropometric, biological markers, risk factors, presence of comorbidities, and the pharmacotherapeutic approach) with the death outcome resulting from ACS patients treated at the Coronary Unit, as well as their differences. Materials and methods: This cross-sectional study included 384 adults with ACS, who were patients of the Cardiology Department with the Coronary Unit of the General Hospital in Valjevo, in 2020. The so-called Coronary Sheet was used as a research instrument. It was created, based on national needs, by the Institute of Public Health of Serbia "Dr. Milan Jovanović Batut", the Institute of Epidemiology, and the Cardiology Society of Serbia. This sheet is in the form of a questionnaire filled out by doctors working at the Coronary Unit, which is then submitted to the Institute of Public Health Valjevo. All respondents gave informed consent for anonymous participation in the research. The obtained data were analyzed using the methods of descriptive and analytical statistics, as well as the methods of univariate and multivariate linear regression. Results: The total sample consisted of 288 (75%) men and 96 (25%) women. The average age of patients who died of ACS was 72.9 ± 9.8 years, while the average age of patients who did not die of ACS was 65.0 ± 12.0 years. The difference was statistically significant (p < 0.001). Statistically significantly more patients who had lower values of both systolic and diastolic blood pressure, when admitted to hospital, died than those who had somewhat higher values of systolic and diastolic pressure at admission (p < 0.001). The mortality rate was lower for patients with ACS who were prescribed acetylsalicylic acid (p < 0.001), beta blockers (p = 0.003), ACE inhibitors (p < 0.001), and statins (p < 0.001) during hospitalization, while all patients whose therapy included inotropes as one of the drugs died (p < 0.001). Conclusion: Our research indicates the existence of a link between the examined determinants and the death outcome in patients suffering from ACS. It is necessary to improve the quality of data, maintain relevant and timely medical documentation and records, and continuously improve prevention programs, with the aim of reducing risk factors for the occurrence of ACS.
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Asrial, An Aldia, Yan Herry, Bahrudin Udin, Novi Anggriyani, and Suhartono Suhartono. "Skor risiko kejadian kardiovaskular mayor di rumah sakit pada sindroma koroner akut dengan elevasi segmen ST yang menjalani intervensi koroner perkutan primer." Medica Hospitalia : Journal of Clinical Medicine 9, no. 1 (March 28, 2022): 20–30. http://dx.doi.org/10.36408/mhjcm.v9i1.640.
Full textAbstract:
Background
Reduction of major cardiovascular events (MACE) in ST elevation acute coronary syndrome (STE-ACS) patients has been achieved by primary percutaneous coronary intervention (PCI) strategy and intensive care management. However, the intensive care unit bed availability and cost remain a problem for those patients, and thus risk stratification using an objective risk score instrument is required.
Aim
To develop a risk score of in-hospital MACE for patients with STE-ACS underwent primary PCI.
Methods
A cohort study of 208 patients with STE-ACS undergoing primary PCI at the Dr. Kariadi General Hospital Semarang. Predictor analysis was carried out using bivariate Chi-Square test and multivariate logistic regression. The obtained independent predictors were then used as risk score variables. The quality of the risk score was tested by the Hosmer and Lemeshow calibration test and AUC ROC analysis for discrimination test.
Results
Seven out of 13 independent predictors, i.e. Killip class (OR 20,04, p=0,0001), age (OR 3,02, p=0,04), renal insufficiency (OR 9,48, p=0,007), infark related artery final TIMI flow (OR 11,57, p=0,001), admission systolic blood pressure (OR 3,04, p=0,025), duration of total ischaemic time (OR 3,14,p=0,032) and increase of blood glucose levels (OR 3,04, p=0,029) were fulfilled the criteria for risk scores of in-hospital MACE. The risk scores had a good quality with the Hosmer and Lemeshow calibration test> 0,05 and ROC AUC 0,886 (95% CI, 0,827-0,944, p <0,005).
Conclusions
A risk scoring modele consisting of 7 independent predictor variables i.e. Killip class, age, renal insufficiency, infark related artery final TIMI flow, admission systolic blood pressure, duration of total ischaemic time, and increase of blood glucose levels (KARIADI) has a good calibration and discrimination in predicting the risk of in-hospital MACE in patients with STE-ACS underwent primary PCI.
Keywords
Predictors of in-hospital MACE, primary PCI, ST-segment elevation acute coronary syndromes, risk score.
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Kornelius, Cyntia, Darwati Muhadi, and Mansyur Arif. "HITUNG TROMBOSIT DI SINDROM KORONER AKUT TERKAIT LOW MOLECULAR WEIGHT HEPARIN (LMWH)." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 18, no. 3 (October 14, 2016): 191. http://dx.doi.org/10.24293/ijcpml.v18i3.376.
Full textAbstract:
Heparin and Low molecular weight heparin (LMWH) had been used widely for prevention and treatment of thrombosis in the patients with acute coronary syndrome (ACS). Actually, the administration of heparin may caused some adverse effect, such as heparin inducedthrombocytopenia (HIT). This study was aimed to reveal thrombocytes count in patients with ACS who underwent LMWH therapy. An observational study with cohort prospective design was performed in 30 patients with ACS. The thrombocytes count was obtained from complete blood count (CBC) by using haematology analyzer (Sysmex XT 2000i) that performed at Clinical Pathology Laboratory, Dr. Wahidin Sudirohusodo Hospital, Makassar. The obtained data was analyzed with Wilcoxon test. The mean thrombocytes count before the administration of LMWH was 236.800/μL, while mean thrombocytes count after the administration of LMWH was 280.270/μL. Suprisingly this data showed that in general thrombocytes count was increased significantly (P=0.004) five day after starting LMWH therapy. In this study only one (3.3%) of 30 patients who received LMWH had trombocytes count less than 150.000/μL. Based on this study an antibody test to PF4-heparin complex was needed to determined occurance of HIT in this patient. The thrombocytes count was increased significantly (P=0.004) in patients with ACS who had given LMWH therapy.
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Pranata, Raymond, Nico Kusuma, Rachel Vania, and Bambang Budi Siswanto. "Role of Highly Sensitive Cardiac Troponin T Assay in Stable Coronary Artery Disease." Indonesian Journal of Cardiology 39, no. 1 (August 21, 2018): 44–49. http://dx.doi.org/10.30701/ijc.v39i1.794.
Full textAbstract:
Cardiac troponins (cTn) are the preferred biomarkers of myocardial necrosis, usually used for diagnosis and risk stratification in acute coronary syndromes. Highly sensitive troponin T (hs-cTnT) may be elevated in stable coronary artery disease (SCAD), in which subclinical plaque erosion or rupture and distal embolization and subclinical ischemic episode. hs-cTnT may be used as a prognostic marker in SCAD and can predict cardiovascular events and patient’s mortality rate. In this article, plaque characteristic that is linked to hs-cTnT, it’s used as prognostic biomarker and comparison to other indicators are the focus of discussion.
Abstrak
Troponin adalah biomarker yang paling disukai untuk mendeteksi nekrosis miokardium dan untuk mendiagnosis dan stratifikasi risiko pada sindrom koroner akut. Highly sensitive troponin T (hs-cTnT) dapat meningkat pada penyakit jantung koroner stabil dimana terjadi ruptur plak atau erosi dan embolisasi distal sublklinis, dan episode iskemik subklinis. Sehingga biomarker tersebut dapat digunakan sebagai marker prognostik pada penyakit jantung koroner stabil dan dapat memprediksi angka kejadian kardiovaskular dan tingkat mortalitas pasien. Pada artikel ini akan dibahas mengenai karakteristik plak yang dihubungkan dengan peningkatan hs-cTnT, pengunaan sebagai biomarker prognostik dan serta perbandingan dengan indikator lainnya.
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Harun, Haerani, Uleng Bahrun, and Darmawaty ER. "PLATELET-LYMPHOCYTE RATIO (PLR) MARKERS IN ACUTE CORONARY SYNDROME (Platelet Lymphocyte Ratio (PLR) sebagai Petanda Sindrom Koroner Akut)." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 23, no. 1 (April 11, 2018): 7. http://dx.doi.org/10.24293/ijcpml.v23i1.1176.
Full textAbstract:
Sindrom Koroner Akut (SKA) merupakan puncak manifestasi klinis aterosklerosis di arteri koroner. Inflamasi terjadi dari tahapawal pembentukan ateroma sampai ruptur plak dan trombosis. Trombosis memainkan peran penting dalam perjalanan penyakit SKA.Trombositosis dan limfopenia berhubungan dengan derajat inflamasi sistemik dan Rasio Platelet Limfosit (PLR) menjadi petanda baruyang melibatkan kedua tolok ukur hematologi tersebut. Penelitian ini merupakan penelitian retrospektif di Rumah sakit Dr. WahidinSudirohusodo Makassar dengan mengambil data pasien SKA UAP, STEMI, NSTEMI dan menilai PLR dari pemeriksaan darah rutin saatmasuk Rumah sakit. Data PLR dibandingkan berdasarkan jenis SKA, kemudian dibandingkan dengan kontrol sehat. Hasil penelitiandidapatkan 223 data pasien SKA UAP, STEMI dan NSTEMI masing-masing 89, 68, 66 data dan kontrol normal 198 data. Hasil ujistatistik Kruskal wallis menunjukkan perbedaan bermakna PLR antara pasien UAP, NSTEMI dan STEMI (p=0,011). Hasil uji post hocmenunjukkan perbedaan bermakna antara UAP dan NSTEMI (p=0,023), UAP dan STEMI (p=0,006), tetapi tidak berbeda bermaknaantara NSTEMI dan STEMI (p=0,827). Nilai PLR pasien SKA lebih tinggi dibandingkan dengan pembanding (p=0,037). Berdasarkanhasil penelitian didapatkan nilai PLR meningkat di SKA dibandingkan dengan kontrol normal. Nilai PLR di STEMI dan NSTEMI lebihtinggi dibandingkan UAP, kemungkinan berhubungan dengan pembentukan trombus dan infark miokard.
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Pradelli, Lorenzo. "Gli antagonisti del recettore GPIIb/IIIa: farmacologia, clinica ed economia nelle sindromi coronariche acute NSTEMI e nelle rivascolarizzazioni per via percutanea." Farmeconomia. Health economics and therapeutic pathways 6, no. 4 (December 15, 2005): 305–16. http://dx.doi.org/10.7175/fe.v6i4.850.
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Inhibition of platelet glycoprotein IIb/IIIa (GP IIb/IIIa) receptor prevents platelet aggregation by controlling its final common pathway, the cross-binding of fibrinogen, bridging across adjacent platelets. Three pharmacological agents capable of inhibiting GP IIb/IIIa are available for use in Italy: abciximab, eptifibatide and tirofiban. In this paper, some relevant studies on the pharmacology of GP IIb/IIIa inhibitors are summarized, as well as the main clinical trials assessing their use in the management of unstable angina (UA) and during percutaneous coronary interventions (PCI). Furthermore, the recommendations on their appropriate use in UA and PCI issued by authoritative scientific societies are presented. Finally, some of the pharmacoeconomic evidence published in the international literature is reviewed and implications in the Italian health care setting are discussed.
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Dewiasty, Esthika, Idrus Alwi, Dharmeizar Dharmeizar, and Kuntjoro Harimurti. "Peran Estimasi Laju Filtrasi Glomerulus (eGFR) sebagai Prediktor Mortalitas pada Pasien Sindrom Koroner Akut selama Perawatan di ICCU." Jurnal Penyakit Dalam Indonesia 3, no. 4 (January 27, 2017): 193. http://dx.doi.org/10.7454/jpdi.v3i4.52.
Full textAbstract:
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
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Bastać, Mila, Dušan Bastać, Anastasija Rašanin, Zoran Joksimović, Vojkan Čvorović, Biserka Tirmenštajn-Janković, Stanislav Tadić, Jasna Strajnić, Maja Mladenović, and Igor Đorđioski. "Damage to the cardiovascular system and complications in Covid-19 infection with a focus on the post-acute covid19 syndrome." Timocki medicinski glasnik 47, no. 2-3 (2022): 104–18. http://dx.doi.org/10.5937/tmg2202104b.
Full textAbstract:
The causative agent of severe acute respiratory syndrome, corona virus 2 (SARS-CoV-2), the etiological agent of the COVID-19 disease, can infect the heart, vascular tissues and circulating cells via angiotensin-converting enzyme 2 (ACE-2), a cell receptor host for the viral spike protein. The focus of this review article is on the prevalence, risk factors, pathogenesis, clinical course and sequelae of myocardial damage caused by the disease COVID-19. Emphasis is also placed on the interactions of platelets with the vascular endothelium, which includes consideration of the role of the SARS-CoV-2 virus protein in triggering the development of generalized endothelitis, which further in a circle triggers more intense activation of platelets. Acute cardiac lesion is a common extrapulmonary manifestation of COVID-19 with potential chronic consequences. Clinical manifestations include direct cardiac damage and indirect immune response mechanisms that affect the cardiovascular (CV) system and have implications for the treatment of patients after recovery from acute COVID-19 infection. The most common direct cardiovascular lesion is an acute heart lesion, present in more than 12% of all infected patients and defined by a significant increase in cardiac troponins in the serum and echocardiographic signs of damage to the myocardial texture due to inflammation, impairment of segmental mobility or global systolic and diastolic function of the left ventricle and sometimes inflammation of the pericardium. Arrhythmias, venous thromboembolism and cardiomyopathy are predominant KV manifestations described in the patient with COVID-19. An analysis of 72,314 confirmed cases of COVID - 19 (Wuhan) showed total mortality of 1663 patients or 2.3%, with presence of a previous KV disease in 10.5%, diabetes Mellitus in 7.3% and arterial hypertension in 6%. Cardiovascular complications because of COVID-19 associated with comorbidities were: myocardial lesion (20 %), cardiac arrhythmias (16%), myocarditis and fulminant myocarditis with lowered ejection fraction (10%), non-occlusive myocardial infarction and venous thromboembolism and acute' cardiac insufficiency and cardiogenic shock. Hypertension and diabetes are the most frequent_comorbidities in those infected with COVID-19, for whom hospitalization was necessary. A Denmark study based on the national register of over 5000 patients with hospitalized COVID19 revealed that the risk from the acute myocardial infarction and ischemic stroke was 5 and even 10 times higher , respectively , during the first 14 days after COVID-19 infections in comparison with the period which preceded the known infection. Numerous individual cases point to extremely high values and troponin T dynamics typicalfor non-occlusive myocardial infarction with normal coronary arteries. Mechanisms of indirect cardiovascular lesions are: dysregulation of inflammatory or immune responses of hyperinflammation, vascular thrombosis and activation of platelets, autoimmune phenomena and adaptive immunological dysfunction in vascular thrombosis associated with COVID-19. Cardiovascular dysfunction and disease are often fatal complications of a severe COVID-19 virus infection. Cardiac complications can occur even canin patients without basic cardiac insufficiency, as a part of acute infections and they are associated with a more severe form of COVID 19 disease and increased mortality. Of COVID-19 patients treated in the intensive care unit 61% died because they had acute respiratory distress syndrome (ARDS), 44% of them had severe cardiac arrhythmias and 31% percent of them experienced a shock syndrome. Elevated troponin levels were rare in survivors of uncomplicated COVID19 (1%-20%), common in critically ill patients (46%-100%), and almost universally elevated in critically ill (ie, those requiring intensive care or mechanical ventilation) and those who did not survive. Some autopsy findings suggested myocardial infiltration by mononuclear leukocytes and revealed some cases of severe myocarditis with a dilated phenotype. Among patients hospitalized with COVID-19, evidence about acute damage of cardiac functions are frequent _ and include the following: acute cardiac insufficiency (3%-33%), cardiogenic shock ( 9%-17%), ischemia or myocardial infarction (0.9%-11%), left ventricular dysfunction (10%-41%), right ventricular dysfunction (33%-47%), biventricular dysfunction (3%-15%), stress cardiomyopathy (2%-5.6%), arrhythmias (9%-17%), venous thromboembolism (23%-27%) and arterial thrombosis as secondary viral mediated coagulopathy. COVID - 19 is associated with abnormalities of cardiac structures and functions including echocardiographic evidence of left ventricular dysfunction, regional wall movement abnormalities and mild reduction of right ventricular function. Involvement of myocardial lesion because of SARS - CoV -2infection was very much widespread even in patients with mild symptoms.
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Wijayanti, Emelia, and Purwanto Adipireno. "Hubungan Kadar Elektrolit Dengan Petanda Jantung Pada Sindrom Koroner Akut." Medica Hospitalia : Journal of Clinical Medicine 7, no. 1 (May 18, 2020): 27–33. http://dx.doi.org/10.36408/mhjcm.v7i1.424.
Full textAbstract:
Pendahuluan: Sindrom koroner akut (SKA) merupakan masalah kardiovaskular utama yang menyebabkan angka perawatan dan kematian yang tinggi. Enzim jantung seperti troponin dan Creatinin Kinase-MB (CKMB) dilepaskan ke peredaran darah dan meningkat pada infark miokard. Elektrolit adalah zat berfungsi untuk menghantarkan listrik. Aktivitas listrik jantung diatur oleh kalsium, kalium dan natrium; kontraksi jantung membutuhkan kalsium, magnesium dan fosfor. Elektrolit berguna sebagai indikator AMI. Penelitian ini bertujuan menganalisis kadar serum elektrolit dengan petanda jantung pada SKA.
Metode: Penelitian belah lintang pada 35 pasien SKA pada bulan Desember - Januari 2018. Kadar elektrolit serum diperiksa dengan metode Ion selective electrode (ISE) dan photometric, kadar CKMB diperiksa dengan metode Enzyme-linked immuno assay (ELISA), kadar Troponin I (cTnI) diperiksa dengan metode Enzyme-linked fluorescence assay (ELFA). Uji Korelasi spearman digunakan untuk menganalisis data, signifikan jika p <0.05.
Hasil: Terdapat korelasi negatif kuat antara natrium, kalium, clorida, dan magnesium baik dengan CKMB (p 0,000/ 0,000/ 0,001/ 0,014 dan r= -0,631/ -0,634/ -0,557/ -0,412) maupun cTnI (p 0,000/ 0,000/ 0,001/ 0,000 dan r= -0,746/ -0,574/ -0,545/ -0,564). Tidak terdapat korelasi antara kalsium baik dengan CKMB (p= 0,475 dan r= -0,125) maupun cTnI (p= 0,086 dan r= -0,294).
Simpulan: Terdapat hubungan negatif antara natrium, kalium, clorida, dan magnesium dengan petanda jantung, tidak terdapat hubungan antara kalsium dengan petanda jantung pada SKA. Temuan ini menunjukkan bahwa rendahnya kadar serum elektrolit pada SKA dapat berarti adanya area infark yang lebih luas. Hasil penelitian ini perlu divalidasi dalam penelitian berskala besar dengan metodologi yang lebih baik dan diharapkan dapat menjadi dasar penelitian lebih lanjut.
Kata Kunci: SKA, Elektrolit, CKMB, cTnI
Introduction: Acute coronary syndrome (ACS) is a major cardiovascular problem that causes significant morbidity and mortality burden. Cardiac enzymes, such as troponin and Creatinin Kinase-MB (CKMB), are released into the bloodstream and increase in acute myocardial infarction (AMI). Electrolytes involving calcium, potassium and sodium regulate heart electrical activity, while calcium, magnesium and phosphorus regulate its contraction. Electrolytes serve as AMI indicators. This study aims to analyze serum electrolyte levels with cardiovascular markers in ACS.
Methods: a coss sectional study of 35 ACS patients was conducted from December to January 2018. Serum electrolyte levels were examined by the Ion selective electrode (ISE) and photometric method, CKMB levels were examined by the enzyme-linked immuno assay (ELISA), Troponin I (cTnI) were examined by the Enzyme-linked fluorescence assay (ELFA) method. Spearman test was perfomed for analyzing data with significant level of <0.05.
Results: a strong negative correlation was found between sodium, potassium, chloride, and magnesium and both CKMB (p 0,000 / 0,000 / 0,001 / 0,014 and r = -0,631 / -0,634 / -0,557 / -0,412) and cTnI (p 0,000 / 0,000 / 0.001 / 0,000 and r = -0,746 / -0,574 / -0,545 / -0,564). No correlation was found between calcium and both CKMB (p = 0.475 and r = -0.125) and cTnI (p = 0.086 and r = -0.294).
Conclusion: There is significant negative correlation between sodium, potassium, chloride, and magnesium and cardiac markers, there is no correlation between calcium and cardiac markers in ACS. These findings indicate low serum electrolytes values in ACS may have higher area of infarction. These finding need to be validated in large-scale studies with better methodologies and are expected to be the basis for further research.
Keywords: ACS, Electrolytes, CKMB, cTnI.